Force  of  Mind;  or, 

The  Mental  Factor  in  Medicine 
by  ALFRED  T.  SCHOFIELD,  M.D.,M.R.C.S. 
Author  of  "The  Unconscious  Mind," 
"The  Springs  of  Character,"  etc. 


iijrpo?   (pt\ddog)oS  iddQenf 


NEW  YORK:  FUNK  AND 
WAGNAI,I,S  COMPANY 
44-60  EAST  23D  STREET  1908 


TO  THE   MBMOBT  OF 
MY   FIBST   TEACHEB  OF   MENTAL   THEBAPBUTI08 

THE   LATE 

HENEY  GAWEN   BUTTON 

PHYSICIAN    AND    PATHOLOGIST    TO    THE    LONDON    HOSPITAL 

THIS   LITTLE   WOBK 
IB  AFFECTIONATELY  DEDICATED 


PBEFACE 

TO 

THE    SECOND    EDITION 


THE  fact  that  a  second  edition  is  already  called  for, 
coupled  with  the  kind  way  the  book  has  been 
received  by  the  medical  profession,  shows  a  marked 
interest  in  the  Mental  Factor  in  Medicine.  The 
author  has  always  believed  that,  in  spite  of  much 
outward  indifference,  there  is  in  the  minds  of  many 
thinkers  a  deep  appreciation  of  the  importance  of 
the  union  of  mind  and  body  which  this  volume  insists 
on.  That  the  '  Force  of  Mind  '  may  be  used  scienti- 
fically in  the  profession  with  greater  effect  is  the 
author's  sincere  hope  and  aim. 

6  HAKLBY  STREET,  W. 
October  1902. 


PREFACE 

TO 

THE    FIEST    EDITION 


THIS  book  is  an  endeavour  to  supply  the  information  Boot 
asked  for  on  April  17,  1897,  by  the  '  British  Medical  answer  to 
Journal '  in  the  following  editorial  note  on  an  address  MedicS 
of  mine  to  the  Victoria  Institute  on  the  '  Scope  of 
Mind.'     It  runs  as  follows  : 

'  This  is  all  very  interesting,  but  some  people 
would  perhaps  like  to  know  how  this  key  to  the 
cause  and  cure  of  many,  if  not  of  most,  diseases  is  to 
be  used ;  and  to  have  one  or  two  diseases  named  in 
which  the  unconscious  mind  plays  the  part  of  causa- 
tion or  cure ;  and  some  suggestion  as  to  the  use  of 
the  knowledge  in  respect  to  cure.' 

This  request,  made  five  years  ago,  is  thus  the 
'  exciting'  cause  of  this  book;  the  'predisposing' 
cause  being  found  in  the  continual  study  of  these 
questions,  necessitated  in  the  treatment  of  functional 
nerve  diseases — no  two  of  which  present  the  problem 
in  precisely  the  same  light ;  and  it  is  written  in  the 
hope  that  those  who  are  really  anxious  to  study  the 


X  THE  FOECE  OF  MIND 

relations  of  mind  and  body  with  regard  to  disease 
may  get  some  assistance  from  the  evidence  I  have 
adduced  on  the  subject. 

Sense  of  I  would  next  remark  that  in  reading  this  book  the 

sense  of  proportion  is  necessarily  lost  between  the 


relative  importance  of  this  '  mental  factor  '  and  all 
the  other  causal  factors  of  disease.  It  is  inevitably 
so  in  any  book  occupied  exclusively  with  one  side  of 
a  question  ;  and  it  must  not  be  supposed  for  a  moment 
that  (as  explained  in  the  text1)  one  does  not  fully 
recognise  that,  after  all,  in  many  diseases  the  part 
played  by  the  mind  is  very  small  indeed,  either  in 
cause  or  cure  —  though  we  believe  that  to  some  extent 
it  is  ever  present.  It  may  also  be  borne  in  mind 
that  a  thousand  books  exist  on  the  physical  factors 
in  disease,  whereas  on  the  mental  factor  hardly  a 
work  can  be  found. 

Bunding  And  again,  in  defence  of  any  zeal  in  pressing  the 
subject  that  may  appear  to  some  readers  excessive,  I 
may  be  allowed  to  point  out  that  I  am  only  too  con- 
scious of  standing  in  a  very  rapid  scientific  and 
material  stream,  whose  current  sets  against  the 
consideration  of  the  subject  here  raised. 

Under  such  circumstances  I  cannot  be  blamed  for 
not  preserving  the  exact  perpendicular  of  a  neutral 
and  colourless  mind.  To  keep  one's  balance  one 
must  lean  over  against  the  current  if  one  is  to 
counteract  its  force,  and  thus  present  a  very  one- 

1  See  Chapter  IV. 


PBEFACE  3d 

sided  appearance ;  for  the  subject  has  to  be  pressed 
and  arguments  reiterated  in  a  way  that  would  be 
quite  unnecessary  in  still  waters. 

Having  tried  to  explain  my  one-sided  attitude  and  A  notable 

omission. 

to  account  for  any  over-zeal  that  might  be  deprecated, 
I  should  like  to  say  one  word  about  an  omission  that 
is  rather  conspicuous.  I  have  soundly  rated  (without, 
I  dare  say,  doing  them  much  harm)  our  modern  text- 
books for  their  rigid  adherence  to  a  mere  descriptive 
level :  wilfully  oblivious  of  the  moving  and  governing 
central  power  that  must  exist  to  bring  the  multifarious 
processes  of  the  body  into  harmony.  But  it  may  well 
be  retorted  that,  though  I  trace  these  to  a  mysterious 
agency  which  I  am  pleased  to  call  the  '  unconscious 
mind,'  I  make  no  attempt  to  show  whence  this  mind 
is  derived.  This  omission  is  not,  however,  due  to 
any  want  of  belief  in  a  First  Cause,  nor  to  any  doubt 
that  this  First  Cause  is  indeed  the  '  God '  of  Christians 
and  of  Revelation,  '  in  whom  we  live,  and  move,  and 
have  our  being,'  but  solely  to  the  fact  that  the 
subject  lies  beyond  the  scope  of  this  work,  which  is 
limited  to  the  powers  and  action  of  the  mind  in  man, 
and  is  not  concerned  with  its  origin  or  even  with  its 
nature. 

Finally,  I  would  earnestly  crave  the  indulgence  of  innumer- 
the  literary  reader,  not  only  for  the  many  avoidable  quotations 
defects  he  will  doubtless  discover,  but  also  for  the  rep 
unavoidable  drawback  of  having  to  make  innumerable 
quotations  and  extracts  in  the  text.  This  cannot  be 


xii  THE  FOECE  OF  MIND 

obviated,  as  it  is  absolutely  necessary  in  seeking  to 
establish  any  new  or  doubtful  point,  to  prove  it  by 
whatever  testimony  one  can  secure ;  and  this  cannot 
be  relegated  to  foot-notes.  No  doubt  the  result  makes 
the  book  less  readable,  but  that  is  a  small  matter  if  it 
makes  it  more  convincing.  To  this  end  also  I  have 
ventured  to  repeat  in  several  chapters  the  same  point 
in  different  words  wherever  it  is  one  of  great  moment, 
knowing  well  from  experience  what  a  help  this  is  in 
these  days  of  rapid  reading. 

impor-  The  whole  subject  is  of  such  value  to  the  medical 

theCwhoie    profession,  and  so  greatly  neglected,  that  I  should  be 
•a  jeo .       m(jee(j  glad  if  the  very  defects  of  this  monograph 
might  rouse  some  abler  pen,  convinced  of  the  impor- 
tance of  the  matter,  to  present  it  in  a  weightier  and 
at  the  same  time  more  attractive  form. 

•  HABLEY  STREET,  W. ! 
August  1903. 


CONTENTS 


MM 

PREFACE  TO  THE  SECOND  EDITION    .        .       •       •       •     vii 
PREFACE  TO  THE  FIRST  EDITION          .       .       •       •    •      iz 


PAET  I 

THE  ACTION  OF  THE  MIND  IN 
CAUSING  DISEASE 

CHAPTER  I 

THE  FORCE  OF  MIND 1 

'Though  leaders  in  the  profession  have  recognised 
the  mental  factor  in  all  ages,  it  is  generally  ignored  to- 
day.' 

CHAPTER  H 

THE  UNITY  OF  MIND 25 

'  As  the  action  of  the  mental  factor  in  disease  is  un- 
conscious, it  cannot  be  recognised  as  mental  by  those 
who  limit  mind  to  consciousness.  The  word  "mind" 
must  therefore  be  extended  to  include  all  psychic  action.' 

CHAPTER  HI 

ON  PSYCHO-PHYSIOLOGY 47 

'  The  double  action  of  the  "  mental  factor  "  on  the 
body  in  health  consists  generally  in  carrying  on  the 
functions  of  life;  and  specially  in  physically  express- 
ing n.ental  states.' 


xiv  THE  FOECE  OF  MIND 


CHAPTER  IV 

rtarn 

ON  PSYCHO-PATHOLOGY  ........      67 

4  The  mental  factor  is  present  in  some  way  or  other 
in  all  diseases.' 


CHAPTER  V 

THE  MENTAL  FAOTOB  IN  ORGANIC  AND  OTHEE  DISEASES 
•  We  have  examples  of  the  mind  as  a  causal  factor  in 
most  organic  diseases.' 


CHAPTER  VI 

THB  CAUSE  AND  SYMPTOMS  OF  FUNCTIONAL  NBBYB  DIS- 
EASE     98 

'The  mental   factor  in  neurasthenia    is  generally 
admitted.' 


CHAPTER  VII 

THE  .ETIOLOGY  OF  HYSTERIA 112 

'The  mental  factor  in  hysteria  it  the  unconscious 


CHAPTER  VILE 

PHENOMENA  AND  ILLUSTRATIONS  OF  HYSTERIA         .        .    182 

'  The  phenomena  of  hysteria  are  due  to  the  perverted 
action  of  the  unconscious  mind.1 


CONTENTS  xv 


PAET  II 

THE  ACTION  OF  THE  MIND  IN 
CURING  DISEASE 

CHAPTER  IX 

MM 

ON  PSYCHO-THERAPY 147 

'  The  force  of  mind  in  therapeutics,  so  largely  ignored 
by  the  profession,  is  generally  exploited  by  quacks  for 
their  own  ends.' 

CHAPTER  X 

THE  vis  medicatrix  natures 168 

4  The  testimony  of  the  profession  as  to  the  presence 
and  importance  of  the  "  vis  medicatrix  naturae,"  and  the 
power  of  mind  over  disease.' 


CHAPTER  XI 

SOME  VARIETIES  OF  MENTAL  THERAPEUTICS        .        .    .    190 

'  The  effective  agent  in  all  faith-cures  is  the  uncon- 
scious mind.' 


CHAPTER  XII 

ILLUSTRATIONS  OF  THE  CURATIVE  POWER  OF  MIND  .        .    211 

'  The  force  of  mind  is  a  therapeutic  agent  in  every 
disease.' 


CHAPTER  XIII 

MENTAL  THERAPEUTICS  IN  FUNCTIONAL  NERVE  DISEASES    225 

'  Functional    nerve   diseases    are    mostly  cured    by 
suggestions  presented  in  various  ways.' 


XVI  THE  FOECE  OF  MIND 


CHAPTER  XIV 

THE  TREATMENT  OF  FUNCTIONAL  NERVE  DISEASES     .    . 
'Success  in  the  treatment  of  neurasthenia  depend! 
equally  on  psychical  and  physical  details.' 


CHAPTER  XV 

THH  THERAPEUTICS  OF  HYSTERIA 268 

'In  hysteria  the  cure  lies  in  restoring  the  healthy 
action  of  the  unconscious  mind.' 


CHAPTER  XVI 

THE  PRACTICAL  CONCLUSION 270 

'  The  neglect  of  the  mental  factor  in  medicine  if  a 
source  of  weakness  to  the  profession  which  should  at  once 
be  removed.' 


LIST  OF  SOME  WRITERS  AND  THEIR  WO«KB  HiSLwm  IK 

STUDYING   THE   MENTAL  FACTOR  IN   MEDICINE     . 


298 


PAET  I. 

THE    ACTION    OF    THE    MIND    IN 
CAUSING    DISEASE 


THE 

FOECE    OF   MIND, 

OB 

THE  MENTAL  FACTOE  IN  MEDICINE 

*  irjrpbs  ^tXoo-o^os  «ro0eos ' 

HIPPOCRATES 

CHAPTER  I 
TEE  FOECE  OF  MIND 

1  Though  leaders  in  the  profession  have  recognised 
the  mental  factor  in  all  ages,  it  is  generally  ignored 
to-day.' 

ONE  of  the  most  charming  medical  biographies  recently 
published  is  the  Life  and  Letters  of  Sir  James  Paget  James 
by  his  son.  It  stands  a  model  of  what  biographies  Paget' 
should  be,  alike  in  its  simple  diction  and  the  natural 
manner  in  which  we  are  allowed  to  see  the  character 
of  the  man  himself  growing  before  our  eyes  ;  revealed 
perhaps  most  fully  in  his  private  letters  to  his  friends. 
Its  greatest  charm  lies  of  course  in  the  personality 
it  describes,  and  we  may  say  that  such  a  man  en- 
riches and  ennobles  the  whole  profession  to  which 
he  belongs.  No  one  can  rise  from  the  perusal  of  this 
book  without  feeling  a  better  man,  a  sense  of  the 
dignity  of  labour,  and  the  certainty  of  the  ultimate 
reward  of  a  consistent  and  straightforward  life. 


THE  FOECE  OF  MIND 


A  letter 
to  Sir  H. 
Acland 


i»  a  mirror 
of  the 
writer's 
mind, 


and  of  the 
medical 
mind  of 
1866. 


We  allude  to  it  here  because  our  subject  is  '  The 
Mental  Factor  in  Medicine,'  and  it  chances  that  this 
volume  contains  some  remarkable  testimony  on  this 
head. 

The  sentence  we  would  quote  is  part  of  a  letter 
from  Sir  James  Paget  to  Sir  Henry  Acland  written 
in  1866,  and  reads  as  follows  : l  '  What  unsatisfactory 
.  .  .  cases  these  are !  This  clever,  charming,  and 
widely  known  lady  will  some  day  disgrace  us  all  by 
being  juggled  out  of  her  maladies  by  some  bold  quack, 
who  by  mere  force  of  assertion  will  give  her  the  will 
to  bear,  or  forget,  or  suppress  all  the  turbulences  of 
her  nervous  system.' 

Now  such  a  letter  is  absolutely  invaluable,  and  for 
this  reason.  Any  conscious  effort  to  reveal  one's 
mind  or  spirit  mostly  ends  in  failure.  It  is  when  the 
conscious  mind  is  diverted  elsewhere,  and  the  man 
is  unaware  of  being  observed,  that  the  unconscious 
mind  shows  as  in  a  mirror  the  true  soul,  the  real 
thoughts  of  the  ego.  A  casual  letter  to  a  friend  reveals 
more,  therefore,  in  its  unstudied  phrases  than  an  elabo- 
rate essay  could  do  upon  the  subject.  Every  thoughtful 
physician  knows  the  real  illuminating  value  of  letting 
a  patient  describe  his  symptoms  in  his  own  language, 
however  quaint ;  and  how  he  learns  thereby  more  of 
the  inner  working  of  the  disease  than  by  the  most  cun- 
ning phrases  which  he  puts  into  the  patient's  mouth. 

It  is  so  here.  This  illuminating  letter  pictures 
unconsciously  as  in  a  glass  the  attitude  of  the  medical 
mind  of  1866  towards  mental  therapeutics — a  mind 

1  Sir  James  Paget :  Life  and  Letters  (Longmans,  4th  edit.  p.  277). 
Extract  of  letter  to  Sir  H.  Aoland  (we  have  given  the  whole 
extract). 


THE  FOECB  OF  MIND  3 

which  is  not  so  very  much  changed  in  1902.    Many  of 
our  readers  will  find  their  own  thoughts  reflected  in  it. 

Translated  into  bald  prose,  it  sets  forth  '  that  the  A  bald 
disgrace  of  the  writer,  of  Sir  H.  Acland,  and  other  frTns- 
eminent  colleagues  is  expected,  owing  to  the   power  lation< 
possessed  by  some  "  bold  quack  "  to  cure  an  attractive 
patient  of  Sir  James  Paget's  through  her   mind  by 
mere   "  force   of    assertion ; "    the  process    of    cure 
apparently  consisting  of  the  lady  "  being  juggled  out 
of  her  maladies." ' 

Such  an  unconscious  revelation  of  the  thoughts  of 
a  great  and  powerful  teacher  demands  our  closest 
attention ;  and  an  analysis  will  be  found  to  well 
repay  the  time  it  may  require. 

The  general  picture  it  presents  is  at  first  sight  An 

,       ,     .    ,  .  amazing 

absolutely  amazing.  picture 

We  see  these  justly  distinguished  men  sitting 
down,  and  calmly  awaiting  their  inevitable  disgrace 
(with  a  fatalism  worthy  of  Hindoo  fakirs),  at  the 
hands  of  '  some  bold  quack,'  in  the  cure  of  this 
'  clever  and  charming  lady,'  whom  they  all  seem 
powerless  to  help. 

Try  and  realise  for  a  moment  the  horrid  conceit  it*  effect 
of  the  '  bold  quack  '  who  reads  this  letter,  and  whose  °boiae 
powers  over  this  '  widely  known  lady '  are  thus  ac-  quaob< 
credited  by  the  leaders  of   the  medical   profession, 
themselves  paralysed  by  impotence. 

We  must  feel  instinctively  that  '  something  is 
very  wrong  somewhere '  for  such  a  grotesque  picture 
to  be  possible ;  and  the  pathos  is  that  it  should  be 
drawn  by  the  pen  of  such  a  man  as  Sir  James  Paget. 

Surely,  on  consideration,  the  '  unsatisfactory  case  ' 
of  which  the  letter  speaks  is  rather  that  of  the 


THE  FOECB  OF  MIND 


The  lady'g 
view  of  the 
matter 


medical  profession  than  of  the  charming  and  widely 
known  lady ;  and  this  the  word  '  disgrace '  seems  to 
confirm. 

The  lady's  own  view  of  the  matter  would  be  most 
interesting,  and  if  medical  men  only  practised  a  little 
more  the  art  of  putting  themselves  in  their  patients' 
place,  they  would  not  be  surprised  to  find  how  widely 
their  views  differ  from  their  doctors'.  The  lady  in 
question  doubtless  would  feel  very  grateful  to.  the 
quack ;  and,  so  far  from  thinking  her  case  unsatis- 
factory, would  only  apply  this  epithet  to  her  previous 
treatment  by  physicians,  of  whom  we  fear  she  would 
say  some  unkind  things. 

Is  it  not  extraordinary  what  value  the  public 
attach  to  such  a  trivial  matter  as  '  cure ; '  and  yet 
how  utterly  incapable  they  seem  of  grasping  the 
importance  of  '  diagnosis '  ? 

What  after  all,  then,  makes  such  a  picture  possible  ? 

Can  it  be  that  the '  bold  quack  '  wields  some  power 
heaimg  called  '  mere  force  of  assertion '  that  the  physician 
virtue  lie  ?  either  does  not  understand  or  does  not  condescend  to 
use?  Does  the  virtue  lie  in  the  'boldness  of  the 
quack,'  in  the  'force  of  the  assertion,'  or  in  both? 
In  both  probably;  and  I,  personally,  may  assert 
'  with  some  force '  that  their  acknowledged  value  by 
such  a  man  as  Sir  James  Paget  proves  that,  in  his 
opinion,  the  '  mental  factor  '  can  not  only  cause,  but 
cure  disease  ;  and  that  it  can  be  made  available  '  by 
force  and  boldness.' 

The  '  widely  known  lady '  does  not  know  this, 
and  the  'bold  quack*  himself  is  probably  equally 
ignorant,  and  in  neither  case  are  we  surprised ;  but 
we  are  amazed  and  justly  indignant  that  a  force  so 


'Cure1 

versus 
diagnosis. 


Where 
does  the 
healin 


THE  FOECB  OF  MIND  5 

potent  and  so  sure  can  be  wielded  with  success  by  a 
charlatan  ;  to  the  disgrace  (to  use  his  own  words)  of  Why  b« 
such   a  profession  as  that  which   Sir   James  Paget  by8gr 
adorned.     It  is  a  sign  of  grace  that  it  is  owned  to  be  v»«*«yf 
a  disgrace ;  and  it  is  with  the  hope  of  being  able  to 
do  something  to  remove  such  a  disgrace  that  these 
pages  are  written. 

It  is,  further,  very  significant  of  the  psychological 
standpoint  of  the  period  that  this  lady  is  cured  by 
'  being  juggled  out  of  her  maladies.'  The  phrase  is 
most  instructive,  and  the  words  show  exactly  what 
was  passing  in  the  writer's  mind.  The  maladies  are  what  is 
confessed,  and  not  dubbed  *  imaginary' — an  added  j^gieVr 
insult  which  is  unfortunately  only  too  common  in  the 
lips  of  inferior  men.  But  they  are  cured  by  'jugglery ' 
— another  word  for  conjuring,  or  producing  effects 
without  obvious  means.  A  black  draught  and  a  blue 
pill  are  noble,  obvious,  and  palpable  professional 
remedies.  But  'force  and  boldness*  are  such  in- 
tangible, such  unorthodox  drugs ! 

And  yet,  sooner  than  stand  disgraced  by  bold  quacks, 
it  would  be  well  if  the  profession  tried  such  means ; 
and  more  especially  when  their  effects  on  the  patient 
are  regarded  so  favourably  by  Sir  James  Paget ! 

Why,  in  the  name  of  J3sculapius,  should  the  pro- 
f ession  have  to  look  to  a  quack  for  boldness  and  force  ? 
Is  there,  then,  no  dignity  and  authority,  no  courage  and 
impressiveness  in  a  physician's  personality  ?  Are  we 
to  believe  that  he  has  not  sufficient  command  of 
language  to  be  able  to  make  assertions  of  any 
required  strength  ?  There  are  many  words  besides 
'  Abracadabra '  that  will  strike  a  patient  with  awe. 

I  admit,  to  the  ignorant,  and  to  those  only  accus- 


6 


THE  FOECE  OF  MIND 


Mental 
thera- 
peutics 
are  not 
'  jugglery.' 


Disgust  at 

irregular 

tactics. 


The 

'regular 
and  the 
1  quack '  in 
South 
Africa. 


The 

wisdom  of 
learning 
from  the 
•nemy. 


tomed  to  the  heavy  material  methods  of  pharma- 
ceutical therapy,  the  process  may  look  like  jugglery  ; 
but  so  would  vaccination  appear  in  the  days  of  Jenner 
to  the  ordinary  medical  mind  of  the  period,  as  indeed 
it  does  now  to  a  large  section  of  the  laity. 

Moreover,  we  cannot  help  feeling  that  this  inter- 
esting letter  which  we  have  considered,  carries  with 
it  a  distinct  impression  beyond  what  is  expressed 
verbally.  It  is  pervaded  by  a  not  unnatural  feeling 
of  disgust  that  tactics  so  unprofessional  in  the  hands 
of  an  outsider  prove  successful  where  all  orthodox 
manoeuvres  directed  by  experienced  officers  have 
failed. 

I  couch  the  phraseology  somewhat  after  a  military 
manner,  for  it  seems  to  me  well,  before  leaving  this 
instructive  insight  into  the  mind  of  a  great  man,  to 
draw  the  remarkable  parallel  that  exists  between 
the  disgust  we  notice  in  the  letter  and  the  same 
feeling  in  a  somewhat  similar  situation  to-day.  Let 
South  Africa  itself  represent  the  chronic  invalid — the 
clever,  charming,  and  widely  known  lady.  In  the 
British  Army  we  have  the  orthodox  practitioner  of 
stereotyped  pattern,  while  the  bold  quack  stands  con- 
fessed in  the  wily  Boer,  who  at  one  time  might  have 
succeeded  in  annexing  the  charming  patient  by  his 
'jugglery.'  (Perhaps  the  simile  may  seem  clumsy 
and  laboured,  but  it  is  in  the  feeling  of  disgust  common 
to  both  that  we  shall  justify  the  comparison.) 

The  British  Army,  with  its  code  of  military  tactics, 
honour,  and  courage,  stood  bravely  by  its  worn-out 
manuals,  marching  in  proper  formation  at  regulation 
intervals,  to  be  shot  down,  not  indeed  like  a  dog  in  a 
ditch,  but  standing  erect,  brave,  and  true,  honourably 


THE  FOKCE  OF  MIND  7 

conspicuous  against  the  skyline,  until  matters  had 
reached  such  a  parlous  state  that  it  became  absolutely 
necessary  to  look  into  the  tactics  of  the  enemy.  His 
low,  mean,  contemptible  dodges  had  long  filled  every 
honest  bosom  with  disgust  —  in  his  lack  of  regular 
uniform,  in  his  sneaking,  crawling  advances,  sniping 
behind  a  stone,  and  his  no  less  ignominious  scuttlings 
and  scatterings  when  pursued. 

But  at  last  the  lesson  is  learned,  and  we  behold 
an  amazing  sight  ;  a  painful  one  perhaps,  but  in  it 
lies  victory.  The  British  Army,  after  all,  is  wise 
enough  to  pocket  its  disgust  when  it  perceives  its  own 
code  is  wrong;  and  though  Europe  may  look  on, 
discreetly  smiling  behind  her  hand,  is  not  above 
taking  a  leaf  out  of  the  enemy's  book  ;  and  the  result 
is,  we  behold  the  British  Army  lying  prone  upon  its 
'  abdominal  parietes,'  and  wriggling  from  mound  to 
mound  along  the  veldt  as  slimly  as  the  Boer  himself. 
Without  for  a  moment  comparing  the  tactics  of  the  Let  the 
Boer  with  the  noble  science  of  the  relation  of  mind  and 
matter  in  disease,  let  our  own  medical  profession, 
following  such  an  example,  overcome  any  question  of  lesson. 
feeling,  and  study  in  a  philosophic  and  scientific  spirit 
the  methods  of  '  the  quack.' 

We  must  make  a  definite  advance  in  our  position, 
and  no  longer  sit  by,  while  bold  quacks  use  before 
our  very  eyes  upon  our  own  patients  such  rational 
and  effectual  mental  medicine  as  forcible  assertion  ; 
and  we  must  also  cease  to  dub  as  '  jugglery  '  success- 
ful methods  we  may  not  at  the  moment  under- 
stand ;  knowing  ever  how  much  greater  is  the  sum  of 
truth  than  our  very  partial  apprehension  of  it.  Sir  Vaine  of 
James  Paget  will  not  have  penned  this  melancholy 


letter. 


8  THE  FORCE  OF  MIND 

confession  in  vain  if  it  leads  us  to  the  determination 
that  such  a  force  shall  not  be  left  to  be  exploited  by 
charlatans,  but  shall  be  mastered  and  used  by  those 
who  seek  to  walk  in  the  van  of  our  profession.  Is 
it  too  much  to  hope  that  my  readers  will  agree  with 
the  spirit  of  these  remarks,  which  is  the  spirit  which 
animates  me  to  write  these  pages,  however  little  they 
may  be  able  to  accept  the  terminology  I  shall  use— 
after  all,  a  minor  matter — or  to  receive  as  evidence  all 
the  illustrations  and  testimonies  I  shall  give  ? 
Pay-  Some  time  ago,  at  a  meeting  of  the  British 

Medical  Association,  I  had  to  read  a  paper  bearing  on 
tne  connection  of  mind  and  body,  and  found  myself 
placed,  and  rightly  placed,  in  the  Psychological  Section. 

When  I  stood  up  to  read,  I  faced  an  audience 
composed,  with  hardly  an  exception,  of  alienists,  or, 
in  other  words,  of  those  connected  in  various  ways 
with  asylums.  It  was  evident  that  medical  psycho- 
logy consisted  chiefly  of  the  study  of  diseased  mind, 
and  practically  included  hardly  any  consideration  of 
the  sane  mind  in  relation  to  medicine. 

Yet  undoubtedly  the  action  of  mind  in  disease  and 
therapeutics  is  everywhere  admitted,  and  vaguely, 
tentatively,  and  often  unconsciously  used. 

It  is  not,  however,  a  subject  which  is  studied  in 
our  schools,  or  spoken  of,  or  written  about  by  our 
teachers.  In  fact,  if  this  book  were  called  '  The  Mind 
in  Medicine '  it  would  no  doubt  be  regarded  as  a  work 
on  insanity.  The  title,  therefore,  is  '  The  Force  of 
Mind,  or  the  Mental  Factor  in  Medicine,'  which  avoids 
this  danger.  It  is  also  more  intelligible,  and  has  a 
further  recommendation  which  we  will  unfold  in  the 
next  chapter. 


THE  FORCE  OF  MIND  9 

The  philologist  would  doubtless  suggest  to  us  that  physicians 
the  first  business  of  the  physician  is  to  deal  with  "nfinedto 
physics  and  physic ;  and  that  his  healing  art  must 
therefore  rest  primarily  upon  a  material  basis ;  and 
yet  the  philologist  does  not  in  this  explanation  exhaust 
the  meaning  of  the  word  '  Physician  ; '  for  there  have 
been  few  worthiest  of  the  name  who  have  not  per- 
ceived, it  may  be  dimly,  the  presence  of  the  '  Mental 
Factor,'  and  recognised  the  importance  of  the  psychic 
element  both  to  themselves  and  to  their  patients. 

That  mind  and  body  are  in  some  way  connected  Mind  and 
was  known  long  before  the  Greeks  associated  a  mental 
state  with  a  physical  cause  by  inventing  the  term 
'melancholy'  (black  bile).     It  is  indeed  only  within 
the  last  century  that  the  practice  of  medicine  has 
been   severed   from  its    connection  with   the  black  Medicine 
arts,  witchcraft,  astrology,  phrenology,  quackery,  and  p8eeeud!l-om 
knavery  of  all  kinds  ;  most  of  these  being  more  or  less  g[Jjo 
psychological  in  their  nature. 

The  medical  man  of  the  present  day  values  too  science 
much  his  freedom  from  the  errors  and  mysteries  of 
mediaeval  medicine  not  to  look  with   a   somewhat 
jealous  eye  upon  anything  that  distracts  him  from  his  to-day, 
physical  studies.    He  knows  too  well  what  his  profes- 
sion owes  to  the  inductive  methods  of  diagnosis,  to  exact 
observation  aided  by  modern  instruments  of  precision, . 
to  the  advances  in  physiology,  pathology,  and  bacterio- 
logy, to  be  over-anxious  to  turn  aside  to  the  study  of 
the  interaction  of  the  physical  with  the  psychic. 

Yet,  real  as  the  advance  has  been,  may  I  venture  to 
suggest  that  it  has  perhaps  become  too  one-sided  in 
its  character  ? 

In  medicine,  as  in  most  human  pursuits,  progress  is 


10  THE  FOKCE  OF  MIND 

Medical       too  often  like  a  journey  on  an  Irish  car — accompanied 
Eke^he8      bv  an  unnecessary  amount  of  oscillation  from  side  to 
STiridi0*     s^e'     ^  8c*ence  advances ;  but  in  medicine  par- 
oar,  ticularly  the  zigzag  course  of  this  advance  due  to 
rival  theories  and  schools  of  thought  eloquently  de- 
monstrates the  unstable  equilibrium  of  the  human 
mind. 

Medical  Philosophy  in  medicine  is  not  in  fashion  just  now. 

Lt  of °P  iy  The  sternly  practical  and  scientific  character  of  the 

fashion.       medical  school  training,  the  mechanical  and  chemical 

plane  on  which  our  physiologies  move,  the  strictly 

material  nature  of  modern   pathology,   all  tend  to 

foster  the  belief  that  any  consideration  of  the  psychic 

in  medicine  is   archaic  in   character  and  futile  in 

result. 

To  talk  of  the  patient's  spirits  in  a  case  of  phthisis, 
when  the  bacillus  swarms  in  the  sputa,  seems  to 
savour  of  '  idle  words.'  What  folly  to  speak  of  mind 
influences  in  typhoid  fever,  when  the  enteric  ulcer 
can  be  seen  (post  mortem)  in  the  pathological  theatre  ! 
We  can  catch  and  stain  and  double  stain  the  microbes 
of  many  infectious  diseases  ;  what  nonsense  it  seems, 
then,  to  talk  of  fear  as  a  causal  factor  ! 

Advance  in         In  urging  some  attention  to  the  '  mental  factor ' 

reaUnd6'     I  would  not  for  one  moment  be  thought  to  depreciate 

great.         "m  &Uj  wav  foe  great  and  real  advance  in  the  art  of 

medicine  ;  nor  to  deny  that  it  has  undoubtedly  been  due 

to  a  steady  persistence  in  exact  scientific  observation, 

with  a  rigid  refusal  of  all  d  priori  reasoning.     Many 

are  perhaps  quite  unaware  what  a  vast  gulf  as  to  this 

separates  us  from  the  current  thought  of  even  fifty  years 

ago,  until  they  happen  to  take  up  such  a  book  as  Dr. 

George  Moore's  '  Use  of  the  Body  in  relation  to  the 


THE  FOECE  OP  MIND  11 

Mind,'  published  by  Longmans  in  1852,  and  compare 
it  with  a  modern  treatise  on  physiological  psychology. 

In  spite,  however,  of  all  this,  the  psychic  is  ever  afl 
with  us,  and  a  sober  consideration  of  the  part  it  plays 
in  the  human  organism  can  never  really  be  either  out 
of  date,  or  futile,  or  beneath  the  attention  of  the  busy 
man. 

It  may  be  that  one  reason  why  an  ill-concealed  Reasons 

J  J     .  .  for  medical 

impatience  is  often  felt  when  psychic  causes  are  dislike 
pointed  out  to  the  skilled  experimentalist,  is  that 
they  suggest  a  something  which  he  can  neither  weigh 
nor  measure  ;  and  he  very  naturally  thinks  that  any 
attention  they  receive  is  diverted  from  exact  research 
and  the  exclusive  consideration  of  the  material. 

Another  reason,  surely,  is  the  limitation  of  the 
human  mind,  which,  when  it  has  spent  a  term  of 
years  in  the  steady  study  of  one  class  of  phenomena 
presented  in  medicine,  finds  it  both  painful  and  difficult 
to  consider  another. 

The  'British  Medical  Journal'  (April  12,  1890)  'Britiah 
suggests  as  a  third  reason  the  inherent  difficulty  of 
the  subject  itself : 

'The  influence  of  the  mind  on  the  body  is  a 
subject  whose  study  involves  so  many  of  the  funda- 
mental and  difficult  problems  in  Nature,  that  it  would 
be  strange  if  it  were  popular  amongst  men  whose 
first  aim  is  to  be  practical.' 

To  the  '  Journal '  (of  that  date)  the  study  obviously 
is  not  of  practical  value ;  the  '  practical '  being  clearly 
identified  with  the  '  easy,'  here,  by  implication, 
associated  with  the  '  material  '—a  fallacy  that  is  still 
sometimes  repeated  by  those  who  regard  men  with 
the  eye  of  a  mechanical  engineer. 


12  THE  FOECE  OF  MIND 

Pour  other  Yet  another  authority  suggests  that  the  ignorance 
of  the  medical  man  of  the  period  as  to  the  mental 
factors  in  medicine  is  due  to  four  reasons : — 

1.  Want  of  instruction  in  the  subject  in  medical 
schools. 

2.  The  difficulty  of  the  study  without  teachers  or 
text-books. 

3.  The  uncertainty  of  the  utility  of  the  knowledge 
when  acquired. 

4.  The  dread  of  being  thought  singular  or  old- 
fashioned. 

Modem  The  text-books  of  a  period  give  great  insight  into 

gieTpureiy  the  spirit  of  their  time :  and  every  thoughtful  student 
scientific.  Of  mo(jern  W0rks  on  physiology  and  medicine  must  be 
struck  with  the  increase  of  the  scientific  tone  at  the 
expense  of  the  philosophic.  The  most  recent  physio- 
logies agree  in  dealing  solely  with  apparatus,  structure, 
mechanism,  and  function  on  a  mere  descriptive  level, 
characterised,  it  is  true,  by  the  most  minute  accuracy 
of  detail.  But  there  is  also  such  a  complete  absence 
of  all  consideration  of  the  necessary  co-ordinating 
and  combining  power  which  alone  can  make  of  these 
diverse  machines  and  many  members  one  harmonious 
unity,  one  perfect  man,  that  the  whole  reads  more  like 
a  work  on  physics  than  the  story  of  the  somatic  life 
of  a  human  being. 

Source  of          And  yet  the  unity  in  diversity  displayed  by  the 

SdiverXty  body  in  general,  and  by  its  members  in  particular,  as 

iSed!00*"    much    postulates    a    central   guiding  force    as   the 

co-ordinated   evolutions  of  a  large  army  prove  the 

existence   of  a   commander-in-chief.      Once  this  is 

grasped,  the  importance  of  a  study  of  this  central 

directing  power  will  be  no  longer  denied,  and  its 


THE  FOKCE  OF  MIND  13 

practical  value  will  not  be  lessened  if  the  power  prove 
to  be  mental  rather  than  material. 

Systems  of  medicine,  however  large  and  modern,  Worts  on 
display  the  same  character  as  the  physiologies.     A  JJ^"6 
rather  old  book,  Pereira's  '  Materia  Medica,'  devotes  recognise 
three  pages   out  of  2,360  to  'psychic  therapeutics.'  Sr^1 
Dr.  Shoemaker,  of  Philadelphia,  in  his  '  System  of  PeutioB- 
Medicine,'  spares  one  page  out  of  about  1,200 ;  but  most 
of  the  others,  including  far  larger  works,  devote  none. 

Every  possible,  and  even  impossible,  aid  to  thera- 
peutics is  gravely  discussed  at  length ;  including  the 
values  of  obscure  organic  extracts  ;  of  special  artificial 
forms  of  exercise  under  innumerable  names ;  of  every 
variety  of  light,  heat,  and  Bontgen  ray ;  of  German 
synthetic  compounds  with  barbarous  polysyllabic 
titles  ;  of  patent  foods,  and  of  systems  innumerable ; 
while  not  one  line  is  devoted  to  the  value  of  the 
mental  factor  in  general  therapeutics. 

If  we  turn  from  the  text-book  to  the  class-rooms  Hospitals 
or  hospitals,  polyclinic   or  postgraduate   course,  we  *&&  °lass- 
find    the   same  result.     Students   listen  with   rapt  i^ore 
attention  to  the  latest  methods  in  aseptics,  the  culture  them* 
of  micro-organisms,  the  use  of  antitoxins  ;  they  study 
the  powers  of  phenocoll,  aristol,  protargol,  salophen, 
and  other  well-advertised  Teutonic  drugs  ;  they  discuss 
keenly  the  rival  merits  of  diverse  forms  of  splints, 
sutures,  forceps,  inhalers,  and  various  instruments  of 
precision  ;  they  are  carefully  shown  the  best  methods 
of  physical  diagnosis.     All  these  necessary  and  impor- 
tant factors  in  therapeutics  are  thoroughly  exhausted, 
while  at  the  same  time  the  omnipresent  mental  factor 
is  almost  universally  ignored. 

We  may  even  attend  cliniques  on  functional  nerve 


14 


THE  FORCE  OF  MIND 


Even  in 
nerve 
diseases 
it  is  often 
ignored 


In  practice, 
therefore, 
it  is 

naturally 
neglected. 


Men 
treated 
on  the 
level  of 

machines. 


The 


round  ' 
doctor. 


diseases  where  this  factor  is  predominant  both  in 
cause  and  cure ;  and  while  listening  for  an  hour  to 
the  physical  signs  established  by  tendon  and  skin 
reflexes,  and  trained  and  systematic  observation,  fail 
to  hear  one  word  to  show  that  the  disease  has  had 
other  than  a  purely  physical  origin,  or  that  it  can  be 
cured  by  other  than  purely  physical  means. 

Turning  from  the  teaching  to  the  practice,  we 
cannot  fail  to  see  the  natural  result.  That  which  is 
ignored  in  physiology  is  not  likely  to  be  admitted  hi 
pathology;  what  is  never  taught  in  the  clinique  is 
not  often  practised  in  the  sick-room.  For  though  the 
influence  of  the  mind  over  the  body,  as  well  as  of 
mind  over  mind,  is  everywhere  seen  and  felt,  it  is  at 
the  same  tune  neglected  and  ignored — in  out-patient 
departments,  in  hospital  wards,  in  consulting  rooms, 
and  by  sick-beds — and  hence  the  amazing  spectacle  so 
constantly  seen  of  men  laboriously  trained  in  all 
the  medical  wisdom  of  the  twentieth  century  patiently 
investigating  the  causes  of  disease,  or  earnestly  con- 
sidering methods  of  cure,  without  a  thought  of  the 
ever-present  mental  factor ;  and  sometimes  hardly 
realising  that  the  case  is  that  of  a  suffering  human 
being,  and  not  merely  of  a  machine  that  is  out  of 
order.  Another  factor  that  obliterates  the  '  man ' 
from  the  physician's  mind  is  over-specialism.  This 
has  increased  by  such  leaps  and  bounds  that  the  good 
all-round  physician  once  so  popular  and  so  genial 
has  wellnigh  passed  away,  and  only  hardy  specimens 
still  exist  scantily  in  isolated  districts.  To  him  has 
succeeded  the  pale,  spectacled,  serious,  and  most  pro- 
foundly scientific  student  of  one  of  the  sixty  or  seventy 
parts  into  which,  I  believe,  we  are  now  segmented. 


THE  FOECE  OF  MIND  15 

It  really  becomes  increasingly  easy,  as  one  listens  to  a  The  man 
paper  at  a  medical  society,  to  forget  that  a  '  man '  as  inrfdstten 
such  still  exists;   while  it  is  perfectly  obvious  that  ^enty 
whole  lives  apparently  centre  round  the  '  appendix '  divisions, 
and  the  '  posterior  nares.' 

It  seems  almost  time  that  the  '  man '  specialist  A  *  man  • 
appeared ;  one  who  studies  the  '  altogether,'  to  use  required* 
poor  Trilby's  happy  expression — a  physician  whose 
exclusive  duty  it  should  be  to  study  men  as  men  ;  to 
master  the  marvellous  intricacies  and  dependencies 
of  spirit,  soul,  and  body ;  and  to  be  skilled  to  know 
when  and  how  to  call  on  the  one  to  help  the  other. 
With  such  men  the  profession  would  be  complete ;  but 
it  is  hard  to  bid  farewell  to  the '  all-round  men,'  having 
only  instead  as  their  successors  such  semi -mechanical 
scientists  as  we  have  pictured.  Let  it,  however,  be 
remembered  that  the  character  of  such  successors  is 
not  due  to  deficiency  in  the  men,  but  rather  to  the 
defective  character  of  the  training  they  have  received. 

And  let  it  likewise  be  hopefully  remembered  that  we 
have  everywhere  amongst  us  those '  irregular  regulars ' 
who  refuse  to  be  bound  by  the  traditions  of  the  schools. 

Our  best  have  owned  the  rare  dramatic  power  « Not  the 

Which  gives  to  sympathy  its  lifting  hour ;  body. bu* 

Go  learn  of  them,  the  masters  of  our  Art,  jg  ^> 

To  trust  that  wise  consultant  called  the  heart. 
There  are  among  us  those  who  haply  please 
To  think  our  business  is  to  treat  disease, 
And  all  unknowingly  lack  this  lesson  still. 
'Tia  not  the  body,  but  the  man  is  ill.1 

Apart  from  the  general  character  of  a  training  that 
produces  a  thousand  careful  observers  for  every  exact 

1  Dr.  8.  Weir  Mitchell,  The  Physician,  Philad. 


16 


THE  FOECB  OP  MIND 


Many 

obserrers, 

few 

reasoners. 


Morbid 
minds  and 
meta- 
bolism. 


Monists  or 
dualists  ? 


Professor 
Lodd  on 
reality  of 
mind. 


reasoner,  the  whole  trend  of  modern  thought  has  long 
been  to  force  the  psychical  further  and  further  away. 
The  mind  is  not  only  driven  out  of  the  body,  but  out 
of  the  brain  itself ;  or,  at  any  rate,  is  commonly 
regarded  as  either  a  secretion  of  that  organ,  or  a 
curiously  complicated  mechanical  reflex,  dependent 
on  purely  physical  causes. 

One  paper  read  at  the  British  Medical  Association 
at  Cheltenham  attempted  to  refer  all  morbid  states  of 
mind  to  the  action  of  various  autotoxins  arising  from 
imperfect  metabolism,  and,  though  the  idea  was 
generally  regarded  as  a  reversion  to  the  days  when 
mental  symptoms  and  blue  pill  were  inseparable,  it 
nevertheless  expressed  a  view  as  to  the  material  basis 
of  mind  that  is  current  amongst  experimental 
physiologists  and  their  pupils. 

And  here  we  may  pause  a  moment,  before  pro- 
ceeding further,  to  make  up  our  minds  as  to  whether 
we  are  monists,  believing  exclusively  in  either  spirit 
or  matter  ;  or  dualists,  believing  in  both. 

The  former  case  includes  both  spiritualists  and 
materialists;  the  former  holding  that  matter  is  a 
function  of  spirit,  and  the  latter  that  spirit  is  a  func- 
tion of  matter.  We  need  not  consider  either  of  these 
positions  here  ;  for  in  this  book  we  definitely  take  the 
place  of  Dualists,  believing  in  both  mind  and  body ; 
without,  however,  dogmatising  too  curiously  on  the 
nature  of  the  former.  While  there  is  abundant  room 
for  diversity  of  opinion,  we  may  accept  generally  as 
sufficient  for  our  present  purpose  Professor  Ladd's 
latest  deliberate  statement  on  the  subject  when  he 
says : '  *  The  assumption  that  the  mind  is  a  real  being 

1  Professor  Ladd,  The  Philosophy  of  Mind,  p.  476. 


THE  FOKCE  OF  MIND  17 

which  can  be  acted  upon  by  the  brain,  and  which  can 
act  on  the  body  through  the  brain,  is  the  only  one 
compatible  with  all  the  facts  of  experience.' 

Mind  is  therefore  to  us — mind,  and  matter — 
matter. 

'  We  must  firmly  grasp  the  truth,'  says  Sir  J.  0. 
Browne,  '  that  mind  is  still  enthroned  apart,  inac- 
cessible save  to  itself ;  that  it  has  been  in  no  sense 
evolved  from  matter,  and  that  it  is  altogether  different 
from  the  liberation  of  energy  of  the  highest  sensori- 
motor  centres.1     Herbert  Spencer,  speaking  of  some  Herbert 
who  fear  that  mind  may  possibly  be  interpreted  in  SnXan 
terms  of  matter,  says :  '  There  is  not  the  remotest  matter- 
possibility  of  so  interpreting  it.' 2 

Generally  speaking,  we  may  regard  the  brain  as 
the  principal  seat  of  mind,  although  by  no  means  its 
exclusive  sphere,  which,  indeed,  extends  throughout 
the  entire  organism.  It  is  curious  to  note  here  in 
passing  that  Aristotle  regarded  the  heart  as  the  seat 
of  the  soul,  and  the  brain  as  an  inert  bloodless  body 
used  to  cool  the  heart ! 

As  dualists,  therefore,  the  importance  of  our  sub-  The 
ject  is  apparent  the  moment  it  is  dispassionately  ™5S;tanoe 
considered,  unbiassed  by  its  unpopularity — important 
because  the  mental  is  perhaps  the  one  factor  out  of 
many  that  is  invariably  present  in  some  form  in  all 
disease,  while  in  functional  nerve  disease  it  has,  of 
course,  a  special  and  prominent  place,  and  is  there- 
fore more   readily  recognised,   whereas    in   general 
cases  it  is  easily  overlooked. 

In  spite  of  the  general  apathy  of  which  I  have  so 

1  Sir  J.  0.  Browne  at  Leeds,  1889. 

•  Herbert  Spencer,  First  Principles  of  Psychology. 

•  I 


18 


THE  FOECE  OF  MIND 


recognised 
by  many 
medical 
leaders. 


By 

Brodie, 
Browne, 
and  Tuke. 


Medical 
neglect 
encourages 
quackery. 


loudly  complained,  the  psychological  side  of  disease 
has  been  recognised  by  many  leaders  in  the  profession. 
Hunter,  Laycock,  Gairdner,  Bastian,  Beale,  Clouston, 
Holmes,  Maudsley,  Paget,  Clark,  Beynolds,  besides 
many  others,  speak  of  it. 

Sir  B.  Brodie  says  :  '  It  is  the  business  of  medical 
practitioners  to  study,  not  only  the  influence  of  the 
mind  on  the  body,  but  also  that  of  the  body  on 
the  mind.'  Dr.  Lockhart  Bobertson  points  out 
that '  all  engaged  in  the  practice  of  the  healing  art 
must  learn  to  search  out  and  understand  the  mental 
and  moral  as  well  as  the  material  causes  of  disease.' 

Sir  James  Crichton  Browne  says:1  'Medical  psycho- 
logy belongs  to  our  whole  medical  profession  .  .  .  the 
general  practitioner  cannot  ignore  it.' 

Dr.  Hack  Tuke,  in  a  fine  passage,  says :  '  I  want 
medical  men,  who  are  in  active  practice,  to  utilise  this 
force,  to  yoke  it  to  the  car  of  the  son  of  Apollo,  and, 
rescuing  it  from  the  eccentric  orbits  of  quackery,  force 
it  to  tread  with  measured  step  the  orderly  paths  of 
legitimate  medicine.' 2 

This  last  remark  is  all -important,  and  especially 
when  considered  in  the  light  of  Sir  J.  Paget's  letter, 
with  which  this  chapter  opens.  There  can  be  no 
doubt  that,  had  the  mental  factor  in  medicine  been 
recognised  and  studied  by  the  profession,  quackery 
would  never  have  attained  the  position  it  has  in  our 
day.  The  more  the  range  of  influence  of  the  mind  on 
the  body  in  health  and  disease  is  ignored  or  narrowed, 
the  more  charlatanism  flourishes  and  credits  itself  with 
cures  really  due  to  the  mental  factor  for  which  we  plead. 

1  Leeds,  1889. 

1  Dr.  H.  Take,  Mind  and  Body,  2nd  edit.,  voL  L  p.  xiv. 


THE  FORCE  OF  MIND  19 

The  serious  study  of  this  power  in  therapeutics 
was  never  more  pressing  than  to-day.  'What  we 
need  and  want  in  medicine,'  Dr.  A.  H.  Carter 
said  not  long  since,  '  is  something  corresponding  to 
those  splendid  flashes  of  imagination  which  yielded 
the  heliocentric  theory  of  the  planetary  system,  the 
theory  of  gravitation,  the  undulatory  theory  of  light* 
the  theory  of  evolution,  and  the  germ  theory  of 
infective  disease — some  fundamental  and  far-reaching 
generalisations  in  pathology  and  physiology  which 
would  vivify  and  vitalise  some  part  at  least  of  the  J^1"1™8 
mass  of  dead  material  facts  which  have  been  accumu-  material, 
lated.' 

Any  student  of  a  modern  medical  text-book,  say  on 
physiology,  can  well  understand  how  the  mass  of  dead 
material  facts  which  fill  its  pages  would  be  '  vitalised  ' 
if  their  dependence  on  the  central  directing  force  were 
laid  bare,  and  the  unity  that  underlies  diversity  in  man 
demonstrated. 

Plato  vitalises  the  material  when  he  says,1  *  The  ^e^a 
good  soul  improves  the  body  ; '  Professor  Calderwood  cbuston 
when  he  says,2 '  Mind  and  body  form  a  unity  of  life.  ^^fl 
Mind  so  acts  on  body  that  .  .  .  the  body  performs 
only  a  limited  range  of  its  functions  without  intelligent 
direction.     The  unity  is  that  of  a  rational  life,  mani- 
festing itself  in  a  rationally  directed  physical  life.' 

Professor  Clouston,  speaking  of  Dr.  Laycock,  the 
teacher  of  Hughlings  Jackson  and  Ferrier,  points 
out 3  that  all  the  advantages  are  not  with  the  students 
of  to-day.  In  Laycock's  time  examinations  might 

1  Plato,  Republic,  Book  iii.  403. 

*  Professor  Calderwood,  The  Relations  of  Mind  and  Brain,  p.  817. 

1  T.  S.  Clouston,  Address  Roy.  Med.  Soo.  Edin.,  Oct.  1895. 


20 


THE  FOECE  OF  MIND 


Also 

Professors 
Gairdner 
and  de 
Fleury. 


The  philo- 
sopher, 
priest,  and 
alienist. 


Wise 

physicians 
should 
understand 
spirit,  soul, 
and  body. 


have  been  less,  but  there  was  more  speculation.  To 
him  medical  psychology  and  modern  neurology  owe 
far  more  than  they  acknowledge.  No  man,  before  or 
since,  has  had  so  wide  a  grasp  of  the  position  and 
functions  of  the  brain  and  its  relation  to  mind,  to 
development,  to  bodily  function,  and  to  pathological 
processes. 

Professor  Gairdner,  as  President  of  the  British 
Medical  Association,  says  :  '  We  must  acknowledge 
the  spiritual  element  in  man  is  brought  necessarily 
into  the  sphere  of  the  physician's  daily  work.' 

De  Fleury,  observing  that  the  medical  treatment 
of  mind  is  yet  a  science  in  its  infancy,  says :  '  The 
modern  doctor  must  understand  the  pathology  and 
hygiene  of  the  intellect.  There  can  be  no  doubt  that 
the  fields  of  psycho-physiology,  psycho-pathology,  and 
psycho-therapeutics  are  as  yet  almost  untouched.' 

The  study  of  mind  is  now  mainly  relegated  to  the 
philosopher,  the  priest,  and  the  alienist ;  but  a  sound 
specialism  after  all  can  only  be  built  on  a  solid  and 
broad  generalisation.  Philosophers  and  priests,  how- 
ever, are  students  of  the  mind  and  soul,  and  alienists 
of  the  diseased  mind ;  what  we  need  are  physicians 
trained  in  the  knowledge  of  mind  and  body,  and  who 
thus  would  prove  better  specialists  than  any  of  the 
three. 

Philosophy,  theology,  and  medicine  touch  each 
other  to-day  as  they  have  ever  done  at  certain  points, 
and  there  is  a  transition  ground  which  is  common  to 
all.  On  this  ground  the  physician  should  stand  with 
as  much  authority  as  the  priest  or  philosopher.  The 
Church  no  longer  treats  the  soul  and  ignores  the  man ; 
but  the  case  of  the  human  being  as  a  whole— spirit, 


THE  FOECB  OF  MIND  21 

soul,  and  body  —  is  increasingly  coming  to  the  front. 
And  in  the  same  way  the  wise  physician  must  grasp 
the  underlying  unity  of  the  spiritual  and  material, 
and  recognise  that  if  the  body  may  and  does  influence 
diseases  of  the  soul,  so  does  the  mind  influence  states 
and  diseases  of  the  body. 

I  utterly  refuse  to  regard  the  definite  recognition  No  re.tr°- 
of  the  '  mental  factor  in  medicine  '  as  a  retrogression,  bat  an 
It  is,  on  the  contrary,  a  step,  and  a  great  step,  in 
advance  ;  for  the  day  is  past  when  a  physician  can 
bound  his  knowledge  or  his  practice  by  the  physical. 
Laycock  says  :    '  The  most  eminent   and   successful 
physicians  have  all  been  psychologists  ;  for  a  know- 
ledge of  a  practical  science  of  mind  is  fundamentally 
necessary  to  the  practice  of  medicine.' 

Sir  J.  C.  Browne  said  at  Leeds  in  1889  :  '  Success  Success 
or  failure  in  a  practitioner  often  depends  as  much  on  may 


his  expertness  in  moral  treatment  as  on  his  skill  in 
simples  ;  '  while  Sir  H.  Acland,  speaking  of  the  knowledge 
ideal  consultant,  thus  points  out  his  mental  qualities. 
'  He  is  a  great  artist  (German,  Arzt),  always  genial, 
always  possesses  his  patient  with  the  belief  that  hie 
malady  is  of  personal  interest  to  his  adviser.' 

I  do  not  wish  to  be  too  pessimistic  in  tone,  for  we 
have  reason  to  believe  that  medical  practice  is  in- 
creasingly influenced  by  the  conception  that  man  is 
an  organic  whole,  partly  psychical,  partly  physical  ; 
not  a  mixture,  but  a  compound  of  mind  and  matter, 
so  intimately  united  that  the  body  cannot  be  moved 
without  the  spirit,  nor  the  spirit  without  the  body. 

I  remember  some  little  time  ago,  when  addressing  The  clergy 
a  large  number  of  London  clergy  on  behalf  of  the  r€ 


man  as  a 


National  Health  Society,  impressing  upon  them  that  whole' 


22  THE  FOKCE  OF  MIND 

if  the  physician  cannot  fully  treat  the  body  without 
any  reference  to  the  spirit,  neither  can  the  clergy 
care  for  the  soul  without  any  regard  for  the  body. 
Considerable  impatience  was  shown  by  my  audience 
at  my  spending  any  time  in  elaborating  a  point  which 
to  them  seemed  so  obvious  ;  and  afterwards  they 
told  me  that  the  day  was  past  when  the  conception 
of  Christianity  was  limited  to  the  soul. 

theoreti-  It  may,  indeed,  be  so  in  theory,  but  I  have  some 

L  practice.  doubts  whether  the  influence  of  the  body  upon  the 
mind  is  any  more  practically  recognised  by  many  of 
the  clergy  than  that  of  the  mind  on  the  body  by 
many  physicians.  True,  the  former  have  more 
excuse  for  the  neglect  than  the  latter  ;  for,  while  the 
mind  is  to  some  extent  studied  by  the  physician  as 
well  as  the  body,  there  is  no  study  of  the  physical  (at 
present)  in  a  divinity  course. 

The  So  far  we  have  been  engrossed  with  the  needs  of 

physician  a  ^Q  pa^en^  an(j  w^jj  fae  <jencienCy  Of  our  training  in 

reference  to  him,  but  is  there  not  a  mind  in  the 
physician  as  well  as  in  the  patient  ;  and  may  not 
one  mind  have  some  power  over  another  mind,  as 
well  as  mind  over  body  ?  In  other  words,  may  mind 
not  be  used  in  therapeutics  objectively  as  well  as 
subjectively  ? 

Curiously  enough,  this  question  is,  as  a  rule,  neither 
asked  nor  answered  in  our  schools,  text-books,  hospitals, 
or  consulting  rooms. 

Most  Still,  there  lurks  in  the  mind  of  every  doctor  who 

reads  these  pages  a  suspicion  that  he  has  a  something 


perceive      about  him  which  is  of  value  to  his  patient  over  and 

they  have 

a  personal    beyond  the  outward  and  visible  sign  of  his  faith  in 
drugs,  as  obscurely  manifested  in  the  crabbed  hiero- 


THE  FOECB  OF  MIND  23 

glyphics  on  his  prescriptions.  And  there  is  a 
consciousness,  too,  in  every  actual  or  potential  patient 
who  may  scan  these  lines,  that  there  is  a  something 
about  his  doctor  that  does  him  more  good  than  the 
medicines,  which  indeed  he  rarely  takes.  And  the 
doctor  he  likes  is  the  one  he  sends  for  ;  in  spite  of 
the  fact  that  the  other  doctor  in  the  town  has  a 
greater  scientific  reputation,  and  a  longer  string  of 
letters  after  his  name. 

It  is,  I  think,  sufficiently  clear  that  one  great  cause,  Psychic 
if  not  indeed  the  chief  one,  of  the  difference  between  £3  1  " 
a  successful  and  an  unsuccessful  practitioner  of  similar  succesB- 
medical  attainments  must  lie  in  the  contrast  of  their 
respective   psychic   qualities.     A  man's   physique  is 
something,  even  the  dress  and  carriage  are  something, 
but  neither  is  to  be  compared  with  the  mind  and 
character  as  elements  of  success. 

How  often  do  we  find  ourselves  puzzled  to  account  These  are 
for   the  phenomenal  fame  and  rapid  rise   of  some  re^caSse 
medical  brother,  which,  perhaps,  with  that  touch  of 
professional  jealousy  rarely,  alas  !  wholly  absent,  we 
put  down  to  his  '  cheek,'  or  '  push,'  or  '  advertising 
methods,'   all  of  which  of  course  we  scorn;   when 
the  truth  is  that  his  success  is  due  to  the  value  of  the 
mental  factor  in  medicine,  therapeutically  used  by 
him,  consciously  or  unconsciously,  in  benefiting  his 
patients'  bodies  by  influencing  their  minds. 

How  many  distinguished  ornaments  of  our  profes- 
sion are  wholly  unconscious  of  the  real  agent  which 
has  placed  them  in  their  exalted  position  ! 

There  are  two  mighty  powers  for  good  in  every  Aphy- 
physician  worthy  of  the  name  —  what  he  knows  and  assets  are 


what  he  is  ;  but,  alas  !  as  a  rule  he  only  values  the 

what  he  is. 


24  THE  FOECE  OF  MIND 

former  ;  this  book  is  written  that  he  may  better  value 
the  latter. 

I  venture  to  think  my  opening  thesis  is  now 
fully  proved,  that  '  though  leaders  in  the  profession 
have  recognised  the  importance  of  the  mental  factor 
in  medicine  in  all  ages,  it  is  generally  ignored  to-day.' 


CHAPTER  II 

THE   UNIT7  OF  MIND 

'As  the  action  of  the  mental  factor  in  disease  is 
unconscious,  it  cannot  be  recognised  as  mental  by  those 
who  limit  mind  to  consciousness.  The  word  "mind" 
must  therefore  be  extended  to  include  all  psychic  action.' 

I  HAVE  now  striven  at  some  length  to  show  the  impor-  One 
tance  of  the  mental  factor  in  medicine,  and  pass  on  to 
first  consider  the  essential  point  raised  in  the  sentence  8ettled- 
that  heads  this  chapter  before  I  proceed  to  examine 
how  this  power  can  be  practically  used  for  the 
benefit  of  our  patients.  It  appears  to  me  that  no  true 
grasp  of  any  science  can  be  really  obtained  until  its  Combining 
deep  underlying  principles  and  their  laws  are  grasped. 
The  superficial  diversities  are  apparent  enough,  and 
easily  lend  themselves  to  endless  analyses  and  descrip- 
tions and  investigations  ;  but  the  deep  foundation- 
unities  are  hidden,  and  require  some  searching  to  find 
them.  The  law  of  gravitation  was  one  of  these,  and 
its  discovery  gave  to  the  motions  of  the  heavenly 
bodies,  amid  all  their  apparent  diversity,  an  underlying 
unity  that  explained  the  movement  of  every  star  and 
planet  in  the  heavens.  It  did  no  less  for  dynamics. 
It  is  this  force,  so  far  inscrutable,  that  determines  the 
position  of  every  molecule  of  matter  in  the  universe. 


26  THE  FOECE  OF  MIND 

In  physiology,  amid  the  bewildering  surface  multipli- 
cities of  organs  and  processes,  we  cannot  but  recognise 
also  a  deep  underlying  somatic  unity  preserved  by  some 
The  unity    inscrutable  force.     In  the  science  of  psychology,  if  it 
physiology.  ^  ever  to  rise  from  the  chaos  of  isolated  facts,  so 
pitilessly  described  by  James  as  its  present  condition, 
the  essential  unity  of  all  mental  processes  must  be 
grasped  and  consciousness  no  longer  be  deified,  but 
take  her  place  as  an  invaluable  handmaiden,  who  lights 
up  many  of  these  processes  for  our  inspection  and  under- 
standing ;  leaving  the  rest,  equally  mental  in  character, 
to  be  inferred  and  deduced  by  many  other  means. 
The  The  unity  of  mind  is  a  truth  as  needful  to  lay  hold 

Sfof *      of  as  the  unity  of  body,  and  I  venture  to  say  that,  had  it 
mind.         been  as  firmly  held  as  Newton's  law  of  gravitation,  the 
sciences  not  only  of  psychology  but  of  medicine  and 
physiology  would  have  benefited  by  a  grasp  of  their  sub- 
jects that  they  cannot  possess  as  long  as  the  unconscious 
mind  is  denied,  or  the  mental  factor  in  medicine  ignored. 
James's  I  will  therefore  seek,  as  briefly  as  may  be,  to  give 

of  Smd°n  evidence  in  support  of  James's  definition  of  mind,  which 
goes  far  beyond  consciousness,  when  he  lays  down 
that  '  psychic  action  consists  of  the  pursuit  of  definite 
ends  with  choice  of  means.' 

The  classic  Speaking  of  the  classic  frog,  immortalised  in  every 
physiology,  which,  when  the  foot  of  the  leg  in  which 
the  thigh  had  been  cauterised  with  acid  was  cut  off, 
stroked  the  place  with  the  other  foot  after  the  removal 
of  the  brain  cortex,  James  further  says  :  '  If  purpose 
remains  the  same  where  the  means  are  different, 
there  is  mind.' * 

1  Sir  M.  Foster,  in  his  Physiology,  part  iii.  pp.  980,  981  (7th  edit.), 
doubts  the  association  of  any  intelligence  with  the  '  choice '  shown  by 


THE  UNITY  OF  MIND  27 

With  this  definition  the  fact  of  the  unconscious 
mind  needs  little  further  proof ;  for  in  this  case  all 
those  higher  centres  that  alone  could  possibly  be 
associated  with  consciousness  had  been  removed. 
Flourens'  hens  and  Voit's  pigeons  and  generations  Fiourens1 
of  rabbits  and  guinea-pigs  have  all  added  their  dumb  Voit's 
testimony  to  the  fact  that  psychic  acts  can  be  per-  P'^60118- 
formed  when  all  the  highest  conscious  psychic  centres 
have  been  removed ;  and  this,  not  as  the  result  of 
having  formed  some  artificial  sensori-motor  reflex 
by  dint  of  frequent  repetition,  but  where  acts  have 
been  done  for  the  first  time,  as  the  results  of  nervous 
stimuli.  These  acts,  we  may  add,  performed  wholly 
unconsciously,  vary  in  nothing  from  those  done  in 
consciousness  ;  and  not  only  so,  but  we  may  descend 
further  in  the  scale,  and  see  everywhere  evidence  of 
mental  purposive  action.  If  we  carefully  consider  the 
following  example  of  reaching  a  fixed  end  by  choice  of 
means  in  novel  circumstances,  we  must  feel  that  no 
elaboration  of  mere  mechanism  can  account  for  it. 

The   Arcellae  possess   a   distinct  nucleus   and  a  Purposive 
concave-convex  shell.     In  the  middle  of  the  concavity  aSoaba* 
is  an  opening  through  which  the  pseudopodia  (or  feelers) 
project,  appearing  as  clear  protuberances  at  the  edge 
of  the  shell.     If  a  drop  of  water  containing  Arcellse 
be  placed  under  the  microscope,  it  often  occurs  that 
one  of  them  is  lying  on  his  back,  so  that  the  pseudo- 
podia  cannot  reach  any  support. 

It  is  then  observed  that  near  the  edge  on  one  side 
minute  bubbles  of  gas  appear  in  the  protoplasm,  tilting 

the  frog  in  this  case.  G.  H.  Lewes,  I  may  point  out,  removed  the 
whole  brain  from  a  frog,  after  which  '  there  was  no  lack  of  sponta- 
neous movement,  and  the  animal  remained  quite  lively.' 


28  THE  FORCE  OF  MIND 

it  up  as  it  becomes  lighter,  so  that  the  animal  can 
reach  the  slide  with  its  feelers  and  turn  over.  Then 
the  gas  bubbles  disappear,  and  the  animal  crawls  away. 
Evidence  If  a  little  water  containing  Arcellae  be  put  on  the 
In  £SL.  under  side  of  a  covered  glass,  and  the  latter  placed  in  a 
gas  chamber  (so  as  to  leave  the  drop  of  water  hanging 
unsupported),  the  animalcule  first  sinks  to  the  bottom 
of  the  water  away  from  the  glass.  Finding  here 
nothing  to  lay  hold  of  as  it  expected,  since  the  water 
in  this  case  is  pendent,  large  bubbles  of  gas  are 
developed  in  its  body,  and  the  animal  floats  up  to  the 
glass  again.  If  it  touches  the  glass  so  that  it  cannot 
reach  it  with  its  feelers,  it  then  diminishes  the  gas 
bubbles  on  one  side  or  increases  them  on  the  other, 
so  as  to  tilt  up  one  side  till  it  turns  over.  Then  the 
bubbles  disappear,  and  the  animal  walks  away. 
Whenever  the  Arcellas  are  in  any  inconvenient  position, 
they  correct  it  by  developing  gas,  which  disappears 
when  the  purpose  is  accomplished.  No  mechanical 
theory  can  account  for  this  apparently  intelligent 
psychic  action.1 

Sirwniiam         Sir  William  Dawson   says :    '  An   amoeba   shows 

voiitdon  in*  volition,  appetite,  and  passion.    One,  trying  to  swallow 

amoebae.      a  one-celled  plant  as  long  as  its  own  body,  evidently 

hungry  and  eager  to  devour  it,  stretched  itself  to  its 

full   extent,  trying  to  envelop  the  plant.     It  failed 

again  and  again,  but  repeated  the  attempt ;  until  at 

length,  convinced  of  its  hopelessness,  it  flung  itself 

away,  and  made  off  in   search   of  something  more 

manageable.' 

Romanes  Romanes,  describing  a  fight  between  two  rotifers, 

~~  the  battle  '  lasted  several  minutes,  till  eventually 

Professor  Engelmann,  Pfliiger's  Archiv  filr  Physiologie. 


THE  UNITY  OP  MIND  29 

the  small  rotifer  was  thrown  violently  away.  It  then 
returned  to  the  conflict,  but  did  not  succeed  a  second 
time  in  establishing  its  hold.  The  entire  scene  was 
as  like  intelligent  action  on  the  part  of  both  animals  as 
could  well  be  imagined.' ' 

'If  we  let  our  gaze  travel  beyond  the  creatures  Mind 

,,      ,  i       •  T  f   '    t   IT  i    belowthe 

that  are  possessed  of  a  glimmer  of  intelligence  and  protozoa, 
consciousness,'  says  Maeterlinck,  '  beyond  the  protozoa 
even,  which  are  the  first  nebulous  representatives  of 
the  dawning  animal  kingdom,  we  find,  as  has  been 
abundantly  proved  by  the  experiments  of  Mr.  H.  J. 
Carter,  the  celebrated  microscopist,  that  the  very 
lowest  embryos,  such  as  the  myxomycetes,  manifest  a 
will  and  desire  and  preferences  ;  and  that  infusoria, 
which  apparently  have  no  organism  whatever,  give 
evidence  of  a  certain  cunning.  The  amoebae,  for 
instance,  will  patiently  lie  in  wait  for  the  new-born 
acinetes  as  they  leave  the  maternal  ovary,  being 
aware  that  these  must  as  yet  be  lacking  their  poisonous 
tentacles.' 2 

But  even  this  is  not  all.     Many  physiological  Psychism 
psychologists  (e.g.  G.  H.  Lewes)  have  seen  proofs  of  ^iS 
mental   action   where  the    brain   is   wholly  absent.  centre8- 
There  appears  to  be  some  mental  action  even  in  the 
independent  functions   of   the   spinal   cord   and  its 
ganglia.  Dr.  Macpherson,  of  Edinburgh,  records  a  case 
that  shows  this.     He  says  that  '  a  mere  segment  of  an 
earwig  will  fight  with  a  segment  of  an  Australian  ant, 
under  the  unmistakable  influence  of  rage,  until  exhaus- 
tion or  death  ensues.' 3     Those  who  refuse  to  recognise 

1  G.  Romanes,  Animal  Intelligence,  p.  18. 
f  Maeterlinck,  The  Life  of  the  Bee,  p.  280. 
•  Dr.  Macpheraon,  Mental  Affections,  p.  100. 


80  THE  FORCE  OF  MIND 

mind  below  man,  or  at  any  rate  below  the  higher  verte- 
brates, will  dismiss  all  these  instances  with  the  remark 
inatinct  is  that  all  this  is  the  expression  of  mere  instinct.  But 
sdous  in  instinct  the  end  is  constant  though  the  means  are 
various,  which  is  a  characteristic  of  true  mental  actions 
(James)  as  distinguished  from  merely  mechanical  re- 
flexes, if  indeed  there  are  such  processes  in  the  body  at 
all.  Sensation  is  of  course  present  in  the  spinal  cord, 
which,  however,  as  G.  H.  Lewes  points  out,1  by  no 
means  implies  consciousness.  In  spite,  however,  of 
the  endless  proofs  that  can  be  adduced  of  purposive 
action  of  unconscious  origin,  similar  in  all  essentials 
to  that  performed  in  consciousness,  there  are  psy- 
chologists to  whom  mind  is  still  only  consciousness 
and  only  consciousness  is  mind. 

why  fight          It  may  be  said,  why  fight  over  words  ?    If  English 
words?       psychologists  in   the  main   agree  to  limit  mind  to 
consciousness,  in  order  possibly  to  prevent  the  exten- 
sion of  the  word  to  the  faculties  of  lower  animals, 
what  does  it  matter,  and  what  difference  does  it  make  ? 
Well,  let  us  look  at  the  question  fairly.  Words,  after 
all,  are  not  worth  fighting  for  in  themselves  ;  it  is  the 
thought  that  underlies  them  that  is  of  importance. 
What  do      If  you  say  '  mind  '  and  mean  thereby  the  phenomena 
by  the        that  centre  round  consciousness,  and  I  say  'mind* 
^Sd'?     an(*  mean  aN  those  phenomena  that  are  not  material, 
characterised  generally  also    by  purpose    and    the 
adaptation  of  means  to   ends,   we  mean   two  very 
different  things.     In  both  these  cases  we  necessarily 
restrict  our  remarks  to  human  beings,  for  it  is  the 
misfortune  of  the  narrower  psychology  that  it  cannot 
prove  or  even  admit  consciousness,  nor,  therefore, 

1  G.  H.  Lewes,  Physiology  of  Common  Life,  vol.  ii. 


THE  UNITY  OF  MIND  31 

mind,  in  any  with  whom  it  cannot  exchange  thoughts, 
though  both  may  be  present.     Of   course,  this  cuts  impossible 
both  ways ;  and,  strictly  speaking,  it  is  equally  im-  j5^JyexiBtB 
possible  to  prove  unconsciousness.     The  secondary  outside 
consciousness,  shown  in  so  many  hypnotic  experiments,  conscious- 
of  the   deeper  personality  which   is   revealed  when  nesfl* 
ordinary  consciousness   is   in  abeyance,  may   exist. 
But  we  still  retain  the  term  '  unconscious  mind '  here 
as  the  best  available  term,  seeing  that  we  use  the  word 
'  consciousness  '  simply  in  its  common  signification,  as 
referring  exclusively  to  the  ordinary  consciousness  of 
a  healthy  man ;  and  not  to  any  possible  subsidiary 
consciousness  of  which  he  is  not  conscious. 

But  the  great  evil  of  this  limitation  of '  mind '  is,  NO  mind 
as  pointed   out    elsewhere,   that    its    adherents,   in  SlSSa?* 
common  with  materialists,  Haeckelian  monists,  Jack-  J^*0"™*" 
sonianparallelists,  et  hoc  genus  omne,  unite  in  declaring 
that  all    extra-conscious    processes    are  purely   the 
'  functional  activity  of  the  brain.' 

What  Ebbinghaus  calls  '  the  vulgar  prejudice  of 
the  absolute  distinction  between  mind  and  matter '  may 
bias  the  writer  in  common  with  others,  but  it  is  well 
to  note  that  the  point  does  not  rest  there. 

If  we  grant,  with  Ebbinghaus  and  Spinoza,  that 
mind  and  matter  are  but  two  aspects  of  the  same 
thing,  the  names  then  refer  merely  to  aspects — that  is, 
to  appearances ;  and  if  we  are  to  believe  that  purpose, 
adaptation,  and  what  we  call  signs  of  intelligence  are 
the  marks  of  the  '  mind's  '  appearance,  we  still  reach 
our  definition  of  mind. 

If,  on  the  other  hand,  we  are,  as  already  declared, 
staunch  dualists,  where,  then,  does  the '  conscious  psy- 
chologist '  stand  ?  Between  the  horns  of  a  dilemma. 

D 


32  THE  FOECE  OF  MIND 

The  He  must  either  relegate  all  processes  below  conscious- 

oMhe™*      ness  to  material  agencies — a  concession  of  no  value  to 

•conscious'  the  materialist  or  to  any  else,  or  he  must  destroy  the 

Fo'gist.0"       force  of  words ;   for  no  amount  of  distinctions  he 

may  draw  between  consciousness,  self-consciousness, 

dim  consciousness,  &c.,  can  alter  the  fact  that  processes 

as  purely  mental  in  character  proceed  entirely  out  of 

all  consciousness  as  truly  as  in  it. 

A  name  This  is  no  question  of  choice ;  it  is  a  matter  of 

'"Sio       absolute  necessity,  felt  by  every  writer  on  kindred 

force  ia       subjects,  that  we  should  have  some  intelligible  term 

to  distinguish  the  remarkable  force  this  book  speaks 

of ;  and  it  is  not  to  fight  about  words,  but  on  account 

of  the  necessity  stated  in  the  thesis  at  the  head  of 

this  chapter,  that  I  write  this. 

'Nature1  We  have,  as  a  matter  of  fact,  no  intermediate  word 

*Physio-      *kat  *s  intelligible,  to  describe  anything  between  the 
logy1  are     conscious  mental  and  the  material  or  mechanical,  such 
ntmes?        terms  as  Nature  or  Physiology  being  unintelligible.  We 
are  therefore  forced  either  to  describe  psychic  processes 
as  mechanical  which  are  not  accompanied  by  conscious- 
ness, or  to  extend  the  word  '  mind  '  as  suggested.     I 
There  is  a    have  previously  stated  that  the  unity  in  diversity  shown 
SdtyS111*  by  the  body  as  a  whole  as  much  postulates  a  central 
the  body,     guiding  power  as  the  evolutions  of  an  army  prove  the 
existence  of  a  commander-in-chief.    It  is  curious  to  see 
that  G.  H.  Lewes,  in  his  remarkable  work  on  Physio- 
logy, admits  the  need  of  the  officers,  but  denies  the 
necessity  of  a  general.     He  says  : 1  '  There  is  unity, 
there  is  a  consensus  of  the  whole  organism  ...  it  is 
due  to  organic  subordination  ...  all  act  together 
...  as  all  the  parts  of  an  army  act  together,  by 

1  G.  H.  Lewes,  Physiology  of  Common  Life,  ii.  421. 


THE  UNITY  OF  MIND  33 

officers  and  discipline.    The  unity  is  an  aggregate  of 
forces,  not  a  presiding  force.' 

This  makes  the  body  a  confederation  or  a  syndicate, 
not  a  unity ;  and  thus  stops  just  short  of  the  truth. 

I    may   now,   with    advantage,   quote    Professor 
James's  exact  words  (to  which  I  have  already  alluded) 
in  his  description  of  a  science  erected  on  an  artificial 
basis,  and  ignoring  the  essential  unity  that  underlies 
all  mental  action.    These  are  the  words  : :  '  Psychology  Professor 
is  but  a  string  of  raw  facts,  a  little  gossip  and  wrangle 
about  opinions,  a  little  classification  and  generalisation 
on  the  mere  descriptive  level,  a  strong  prejudice  that  psycho- 
we  have  states  of  mind,  and  that  our  brain  conditions    ogy* 
them ;  but  not  a  single  law  in  the  sense  in  which 
physics  shows  us  laws.     At  present  psychology  is  in 
the  condition  of  physics  before  Galileo  and  the  laws  of 
motion,  or  of  chemistry  before  Lavoisier.' 

Dr.  J.  Macpherson,  of  Edinburgh,  points  out  the  The 
reason  of  this  chaos  : 2  '  The  futility  of  psychology  to  JJ^g 
account  for  the  majority  of  mental  reactions  is  largely  chaos» 
due  to  the  attempt  to  explain  these  by  terms   of 
consciousness.' 

A  psychology  so  hide-bound  lands  us  in  endless 
difficulties.     Bastian  cogently  remarks   that 3  '  if  we 
are,  as  so  many  philosophers  tell  us,  to  regard  the 
sphere  of  mind  as   coextensive  with  the  sphere  of  expiained 
consciousness,  we  shall  find  mind  reduced  to  a  mere  ]^ackenzie 
imperfect  disjointed  series  of  agglomerations  of  feel-  »»d 
ings,  and  conscious  states  of  various  kinds — while  a 
multitude  of  initial  or  intermediate  nerve  actions 

1  W.  James,  Principles  of  Psychology,  i.  468. 

«  Dr.  J.  Macpherson,  Mental  Affections  (1899),  p.  97. 

•  C.  Bastian,  Brain  as  an  Organ  of  Mind,  p.  146. 

D2 


84  THE  FOECB  OF  MIND 

would  have  no    claim  to  be    included   under  this 
category.' 

The  result  on  physiology  is  no  less  disastrous  ;  for, 

following  the  shibboleth  of  psychology,  and  therefore 

consistently   ignoring   any  mental   action   performed 

out  of  consciousness,  it  is  in  a  cruel  dilemma.     Too 

The  chaos    honest  to  attribute  the  purposive  actions  it  observes 

™g£hy&1°~    (at.  any  rate  entirely)   to  sensori-motor  reflexes,  it 

invokes,  even  in  serious  text-books  of  recent  date, 

female  deities  already  known  to  us  under  the  names  of 

'  Nature,'  '  Physiology,'  and  the  like,  to  account  for 

the  phenomena. 

conscious  The  doctrine  of  a  mind  limited  to  consciousness 
automata  pr0(juces  in  man  the  '  conscious  automaton '  of  Hughes 
and  others.  These  affirm  that  emotions  are  laid  on 
the  surface  of  the  man  as  colours  on  a  tile  mosaic, 
and  cannot  affect  the  body  in  any  way.  I  can  only 
say  that  any  view  more  disastrous  to  the  successful 
treatment  of  disease  could  not  well  be  conceived. 

Clifford  also  follows  with  the  same  idea,  that 
all  unconscious  actions  must  be  mechanical  and 
automatic. 

But  with  the  best  scientists  the  days  of  the 
1  conscious  automaton '  are  gone.  The  necessity, 
indeed,  of  invoking  a  '  Nature '  with  a  capital  N  shows 
this.  There  was  a  time  in  physiology  not  so  long 
since,  when  it  was  thought  that  a  mechanical  law  of 
1  vital  ^  diffusion  and  osmosis  accounted  for  the  absorption 
WP'U^.  of  oxygen  and  of  food.  We  know  now  that  both 
are  the  result  of  some  vital  action  which  is 
one  of  the  complex  properties  of  the  epithelial 
cells  that  line  the  alveoli  and  the  digestive  tract. 
These  pursue  a  selective  and  purposive  end  with  a 


THE  UNITY  OP  MIND  35 

persistence  that  no  mechanical  theory  can  explain ; 
nor  is  it  accounted  for  by  the  fact,  so  insisted  on  by 
G.  H.  Lewes,  that  the  vital  phenomena  displayed  by 
the  human  machine  depend  upon  it  differing  from 
ordinary  machines  in  being  essentially  a  sensori- 
mechanism. 

I  will  now  proceed  to  show  by  further  evidence 
that  I  do  not  stand  alone  in  thus  seeking  to  extend 
the  word  'mind'  BO  as  to  embrace  all  psychic 
action.1 

In  1888  the  Aristotelian  Society  held  a  special  MM 
meeting  to  decide  if  '  Mind  is  synonymous  with  Con-  ££ed°to" 
sciousness.'     It  was   settled  in   the  negative.     Pro-  conscious 
fessor    Shadworth    H.   Hodgson,   President    of    the 
Society,  said :  '  It  seems  to  me  that  both  usage  and 
accuracy  of  definition  alike  concur  in  deciding  the 
question  in  the  negative,  for  if  we  identify  mind  with 
consciousness,  what  are  we  to  do  with  those  states 
commonly  called  mental  which  are  below  the  threshold 
of  consciousness,  and  some  kinds  of  which  never  rise 
above  ? '    With  this  Dr.  G.  Ritchie  (Oxford)  and  many 
others  agreed.     I  am  of  opinion  that  this  deliberate 
discussion  and  decision  on  this  subject  carries  con- 
siderable weight,  particularly  when   the  arguments 
adduced  are  considered. 

Eibot  says  of  the  mind,  it  has  two '  parallel  modes  of  Ribot  and 
activity,  the  one  conscious,  and  the  other  unconscious.' 2  ^u^8eley 
Maudsley  points  out  that '  it  is  a  truth  that  cannot  be  8ame- 
too  distinctly  borne  in  mind,  that  consciousness  is  not 
coextensive  with  mind ;  that  it  is  not  mind,  but  an 

1  For  farther  proofs  and  a  review  of  the  whole  subject,  see  the 
Author's  Unconscious  Mind,  2nd  edit.  (Hodder  &  Stoughton). 
*  Eibot,  Heredity,  p.  221. 


3G 


THE  FOECE  OF  MIND 


Professors 
Hofifding 
and  Jamei 
extend 
sphere  of 
mind. 


Mind  can- 
not be 
limited  to 
what  we 
•ee  of  it. 


We  have 

other 

mental 

tenses 

betide* 

sight 


incidental  accompaniment  of  mind  ; '  that '  the  whole 
business  of  mental  function  as  work  might  go  on 
without  consciousness,  just  as  the  machinery  of  a 
clock  might  work  without  a  dial.  It  is  a  necessary 
concomitant,  not  an  energy  at  work  in  the  manufacture 
of  the  mental  organism.  The  misfortune  is  that 
ordinary  language  assumes  it  to  be  a  kind  of  superior 
energy.' *  Professor  Hofifding,  while  himself  confining 
mind  to  consciousness,  admits  that  psychological  laws 
prevail  beyond  the  province  of  conscious  life,  and  that 
conscious  actions  are  largely  the  result  of  unconscious 
influences,  which  determine  a  large  part  of  conscious 
life ;  and  he  compares  conscious  life  to  a  coral  island 
which  rests  on  in  visible  (mental)  strata  below  the  surf  ace. 

Professor  James  not  only  extends  the  scope  of 
mind  beyond  orthodox  limits,  but  denies  that  con- 
sciousness proves  anything.  He  says 2  that  the  fact  of 
'  a  person  feeling  nothing  is  no  proof  that  no  feeling 
has  been  there.' 

Consciousness  after  all  only  represents  what  I  see  of 
my  mind  ;  but  surely  there  are  many  ways  of  detecting 
its  presence  besides  sight ;  and  one  might  as  well  limit 
the  body  to  what  one  can  see  of  it,  ignoring  those 
parts  that  are  discerned  by  touch,  as  make  conscious- 
ness the  only  proof  of  mind.  We  can,  of  course,  see 
the  image  of  our  faces  in  a  glass,  but  we  can  just  as 
clearly  see  the  unconscious  mind  reflected  in  actions, 
and  we  have  no  more  right  to  deny  the  existence  of 
the  one  than  of  the  other.  To  say  you  cannot  know 
you  think  or  feel,  unless  you  are  conscious,  is  to  say 
one  cannot  tell  a  man  is  a  watchmaker  unless  one 

1  H.  Maudaley,  Mind  and  Body,  p.  25,  and  Mind,  xii.  503. 
*  Prof.  W.  James,  Principles  of  Psychology,  i.  211. 


THE  UNITY  OF  MIND  37 

actually  sees  him  make  the  watch ;  whereas  one  reaches 
this  conclusion  by  seeing  the  watch  itself  which  he 
has  made.  In  like  manner,  the  results  of  unconscious 
thought  seen  in  consciousness  prove  the  existence  of 
the  unconscious  mind.  We  must  not  only  get  rid  of 
the  idea  that  consciousness  is  mind,  but  also  that  it  is 
the  only  proof  of  mind. 

Mind,  in  fact,  may  be  conscious,  sub-conscious,  or  Mind  may 
unconscious.  The  second  state  may  be  brought  into  be^ay.no< 
consciousness  by  effort,  the  last  cannot.  SCIOUB. 

Once  this  is  seen,  the  difficulty  felt  from  all  time 
as  to   the  recognition  of  some  unconscious  mental 
power  that  governs   physical  life  disappears.     The  Ancients 
ancients  ever  sought  to  understand  the  unconscious  underhan 
mind,  and  in  modern  writings  we  see  everywhere  men  JJJJ,™ con" 
groping  in  search  of  it.  mind. 

The  word  '  physiology '  was  first  used  by  Hippo- 
crates, and  compounded  from  the  word  'phusis,'  which 
meant  some  essence,  some  spiritual  entity  which  kept 
the  processes  of  the  body  in  order.    Aristotle  included 
in  the  functions  of  his  'Anima'  the  regulation  of 
nutrition  and  other  processes ;  but  Descartes  narrowed  Descartes 
it  down  to  consciousness  under  the  word  '  Mens,'  to  £"££ ™d 
the  great  detriment  of  subsequent  sciences.  amadous- 

The  '  Archaeus '  of  Van  Helmont,  as  Sir  Henry 
Holland  points  out,  as  well  as  the  '  Anima  '  of  Stahl 
and  the  '  Pneuma  '  of  Galen,  refers  to  an  active  im- 
material  principle,   producing    and    controlling   the 
actions  of  the  system,  by  operations  neither  chemical 
nor  mechanical.     These  terms  were  suggested  by  the  Certain 
imperative  need  that  was  felt  and  the  effort  that  resulted  Sventrf. 
to  find  something  intermediate  between  conscious  mind 
and  body — some  middle  agency  that  might  give  a 


38  THE  FOECB  OF  MIND 

show  of  explanation  of  the  actions  of  the  former  on 
the  latter.  No  doubt  many  think  we  have  outgrown 
this  ancient  lore  in  the  twentieth  century,  but  it  is 
not  so ;  nor  can  it  be  so,  as  long  as  the  need  exists  of 
which  there  can  be  no  doubt  at  present. 

Professor  James,  though,  as  we  have  seen,  free 
Question     from  shackles  of  the  old  psychology,  does  not  seem 
consc'iona     wholly    happy  in  the   thought  of    an  unconscious 
mind  ;    and  rather  hugs  his  old  fetters  when  he 
says  !  that  consciousness  may  be  split  up  into  two 
parts,  one  of  which  he  calls  '  a  secondary  or  sub- 
conscious self.' 2 

Female  Hack  Tuke  speaks  of  the  '  automatic  action  of  the 

Worshipped  hemispheres,'  while  Sir  Michael  Foster  and  others 

»n  modem    invoke  (as  we  have  said)  '  Physiology '  herself  and 

y'  '  Nature,'   as  the  female  deities   that  preside  over 

physical  processes.    .In  short,  any  and  every  term  is 

preferred,  however  meaningless  and  unintelligible,  to 

1  W.  James,  Principles  of  Psychology,  i.  210. 

*  Bramwell  and  others  point  out  that  what  we  term  the  uncon- 
scious mind,  which  is  active  in  the  hypnotic  state  and  in  dreams, 
when  ordinary  consciousness  is  in  abeyance,  has  a  consciousness  of 
its  own.  This  doubtless  is  so,  but  involves  with  it  the  idea  of  a 
double  ego.  Now,  writing  as  we  are  for  the  simple  and  prac- 
tical man,  medical  or  otherwise,  it  would  be  the  height  of  folly  to 
obscure  the  plain  issues  here  raised  by  speaking  of  consciousness 
in  any  sense  but  that  ordinarily  used  ;  and  that  is  the  mental  sight 
and  insight  attaching  to  our  ordinary  ego,  and  which  does  not 
embrace  the  states  of  the  'unconscious  mind.'  The  point  is  of 
Interest  as  affording  definite  proof  that  we  have  a  long  range  of  mind 
beyond  the  limits  of  ordinary  consciousness,  and  also  may  show 
that  the  term  '  unconscious  mind,'  like  so  many  others,  may  be  more 
convenient  than  accurate.  But  we  must  refuse  to  pursue  the 
question  of  double,  and  even  treble,  personalities  further  here,  as  this 
whole  chapter  is  only  preliminary  to  our  real  subject,  which  is 
4  The  Mental  Factor  in  Medicine.' 


THE  UNITY  OF  MIND  39 

that  which  seems  to  me  so  accurately  descriptive. 
All  this  and  much  more  show  that  the  need  is  as 
present  as  ever,  and  probably  were  it  not  for  Descartes 
and  his  disciples  the  meaning  of  the  word  'mind* 
would  have  long  since  been  extended  to  meet  it. 

The  '  unconscious  mind  '  is,  then,  the  best  term  I  «  Uncon. 
can  find  for  this  power  which  we  all  have  to  recognise 
in  medicine  ;  and  I  use  the  phrase  in  the  same  way 
that  we  say  '  the  sun  sets,'  as  convenient  and  descrip- 
tive, but  possibly  not  as  severely  scientific  as  it  sounds  ; 
for  psychology  is  as  yet,  as  we  have  seen,  a  science  in 
its  (rather  elderly)  infancy. 

I  have  dwelt  somewhat  fully  on  this  theme  of  the  Great 
'  unconscious  mind  '   because  it  is   perhaps  one  of  J^Portano% 
greater  practical  importance  to  physicians  than  to  any  physicians. 
others,  excepting  parents  and  teachers.     To  these  the 
knowledge  and  study  of  the  unconscious  mind  are 
absolutely  essential  when  the  unconscious  powers  that 
constitute  the  character  are  being  formed,  and  the  lines 
on  which  a  successful  life  may  be  built  laid  down  : 
that  is,  if  the  true  methods  of  education  are  to  be 
understood  and  definite  schemes  of  character-building 
pursued.1     But  it  is  to  the  physician,  as  we  have  said, 
that  this  knowledge  is  all-important,  and  because  of 
these  two  facts  —  first,  that  almost  all  the  action  of 
the  mind  upon  the  body,  as  a  factor  in  disease  or  The  action 
therapeutics,  is  exercised  unconsciously  ;  and,  secondly,  conscl  ^Ts" 


that  most  of  the  action  of  the  physician's  mind  and 
personality  upon  his  patients  is  also  unconscious.   The  The  action 
limits  of  the  powers  of  the  conscious  mind  in  either  conscious 
of  these  two  actions  are  extremely  narrow  and  well- 

1  See  further  on  this  subject,  The  Springs  of  Character,  by  the 
Author.     (Hodder  &  Stoughton.) 


40  THE  FOECE  OF  MIND 

defined,  whereas  unconscious  mental  action  is  indefinite 
and  extensive.  A  physician,  therefore,  who  only 
recognises  the  former,  and  is  compelled  by  his  creed 
to  ignore  the  latter,  necessarily  stands  at  a  great 
disadvantage  ;  we  are  forced,  in  fact,  with  regard  to 
this  matter,  to  use  the  words  of  Bastian : — 
Mind  must  *  This  is  no  question  of  choice,  but  one  of  absolute 
mdude  all  j^gggj^  rpjjQ  meaning  Of  the  word  "  mind  "  must  be 
p^diio  considerably  enlarged  so  as  to  include  ...  as  mental 
action.  phenomena,  the  functional  results  of  all  nerve  actions 
.  .  .  whether  these  nerve  actions  are  accompanied  by 
a  recognised  conscious  phasis  or  no.'  '  Let  us  enlarge 
our  conception  and  definition  of  mind.  Let  us  openly 
profess  that  which  has  already  been  tacitly  implied  by 
many.  Instead  of  supposing  that  mind  and  conscious- 
ness are  co-extensive,  let  us  make  mind  include  all 
unconscious  nerve  actions.  We  must  inevitably  come 
to  this,  and  the  doctrine  of  "  unconscious  cerebration  " 
[Carpenter]  has  served  to  pave  the  way  for  it.  And 
we  are  coming  to  it  rapidly,  and  once  we  reach  it  all 
difficulty  as  to  the  mental  factor  in  medicine  will 
disappear.' ! 

The  idea  The  evolution  of  psychology  itself  shows  that  there 

unit^of      is  progress  even  in  that  science.     The  idea  of  the  unity 

mmwin8       °^  m^n<^  ifl  distinctly  growing.     For   a  long  time 

intellect,  emotion,  and  will  were  studied  and  regarded 

almost  entirely  as  three  independent  entities.     They 

were  self-contained  factors,  connected,  it  is  true ;  but 

the  unity  they  formed  was  largely  lost  sight  of  in  the 

description  of  their  differing  qualities ;  somewhat  in 

1  C.  Bastian,  Brain  as  an  Organ  of  Mind,  p.  148.  I  do  not 
consider  that  mind  consists  of  nerve  actions,  as  the  passage  might 
Imply.  Mind  is  the  psychic  cause  or  result  of  nerve  action. 


THE  UNITY  OF  MIND  41 

the  same  way  that  the  unity  of  the  body  is  often 
forgotten  in  specialism. 

Even  when  the  error  and  fallacy  of  such  a  view 
of  the  mind  as  this  was  seen,  and  the  constant  inter- 
dependence and  inseparable  nature  of  its  three  powers 
were  perceived,  theories  of  isolated  states  of  conscious- 
ness, of  the  atomic  theory  of  mind,  and  other  vagaries 
succeeded. 

But  once  the  unity  of  mind  is  apprehended  even  And  this 
dimly,  it  paves  the  way  for  the  gradual  displacement 


of  consciousness  as  its  synonym.  Of  course  the  struggle  ne88^9  lta 
is  long  and  severe,  and  every  shift  has  been  made  by 
those  who  cling  to  the  old  formula  to  explain  that  the 
unconscious  is  after  all  the  conscious,  or  at  any  rate  in  no 
is  sub-consciousness,  or  sub-liminal  consciousness  or 
secondary  consciousness  ;  in  short  is  a  consciousness 
of  which  we  are  not  conscious.     So  gallantly  will  men 
fight  for  an  old  creed  in  terms  that  show  the  cause  is 
already  lost. 

It  needs  no  words  of  mine  to  prove  that  when 
psychologists  are  reduced  to  such  shifts  it  is  a  sure 
sign  the  truth  is  pressing  hard  upon  them,  and  must 
ere  long  lead  to  a  still  further  revision  of  their  phrase- 
ology, so  as  to  admit  wholly  unconscious  mental 
processes  ;  and  thus  lead  them  up  eventually,  if  logical,  Mind  is 
to  the  position  of  the  more  advanced  teachers  ;  and  to 
recognise  the  grand  psychic  unity,  and  the  fact  that 
mind  is  mind,  whether  illumined  by  the  fitful  rays  of 
consciousness  or  not. 

The  terms  'conscious  mind'  and  'unconscious 
mind  '  are  in  themselves  misleading,  and  give  the  idea 
there  are  two  minds,  and  thus  obscure  its  essential 
unity.  I  only  use  the  latter  term  here  provisionally 


42 


THE  FOECE  OF  MIND 


But 
mind  is 

essentially 
one, 

whether  in 
darkness 
or  light. 


Advancing 

physiology 
proves  the 
unity  of 
Tniud. 


The  latent 
Interval  in 
reflexes. 


until '  mind '  means  all  mind,  and  not  only,  as  now,  a 
small  part  of  it.  The  mind  is  one ;  but,  as  I  have 
said,  while  one  part  is  in  constant  illumination,  another 
is  never  lighted  by  consciousness ;  and  between  the 
two  stretches  a  tract  of  uncertain  extent  that  is  some- 
times in  light  and  sometimes  in  darkness — the  sub- 
conscious region. 

Physiology  leads  the  way  here.  T.  White,  in '  Mind/ 
has  pointed  out l  that '  the  facts  of  physiology  have 
at  length  led  psychologists  to  see  that  states  of  con- 
sciousness form  only  a  portion  of  the  mental  life,  and 
have  as  background  sub-consciousness  and  uncon- 
sciousness. At  first  it  seems  like  a  contradiction  to 
speak  of  facts  of  unconsciousness  as  belonging  to 
psychology  ;  but  when  it  is  considered  that  the  same 
changes  in  the  nervous  system  may  be  accompanied 
by  consciousness,  or  some  sub-conscious  change,  it  is 
evident  that  mind  must  consist  of  other  elements  than 
those  which  appear  in  consciousness.  The  study  of 
physiology  was  necessary  to  bring  out  clearly  the  con- 
ception of  unconscious  feelings  as  facts  in  mental 
phenomena.' 

It  has  been  recently  remarked  physiologically  that 
in  the  sensori-motor  reflexes  as  well  as  in  conscious 
acts  no  continuous  mechanism  has  been  proved,  and 
also  that  the  space  of  time  that  intervenes  between  the 
arrival  of  the  stimulus  and  the  issue  of  the  mandate 
seems  to  postulate  between  the  two  or  between  the 
conscious  causal  idea,  emotion,  or  will,  and  the 
physical  effects  in  the  body,  some  unconscious  agent 
of  mind,  which  produces  results  that  the  initial  cause 
itself  could  not  effect ;  and  there  can  be  no  doubt  that 
'  T.  White,  Mini-.  iL  506. 


THE  UNITY  OF  MIND  43 

when  Golgi  and  Cajal  demonstrated  the  independence  The  a«- 
of  the  neurons  of  Waldeyer  and  the  discontinuance  of 
the  nervous  mechanism  it  gave  a  better  physiological 
basis  for  the  existence  of  the  unconscious  mind,  which 
may  constitute  the  necessary  link  and  agent. 

It  has  also  long  been  observed  that  but  very  few 
of  the  effects  on  the  body,  even  in  the  case  of  the  con- 
tractions of  the  voluntary  muscles,  are  the  definite 
purposive  result  of  the  action  of  intellect,  emotion, 
or  will.      On  nearly  all,  the  mind  can  consciously 
only  act  indirectly  ;  by  this  means  we  can  will  the  Conscious 
purpose,  but  not  the  means.     The  predisposing  cause  SSSpoSg, 
of  the  bodily  state,  we  may  say,  is  the  conscious  mind  JJJSS" 
and  will;    the  exciting  or  efficient  cause  is  the  un-  mind 

.     ,  exciting. 

COnSClOUS  mind.  cause  of 


Perhaps  I  may  pause  here  for  one  moment  in 
the  belief  that  the  non-psychological  reader,  whose 
eyes  must  have  widened  as  he  reads  the  story  of 
the  horrid  conflict  this  chapter  records  over  the 
meaning  of  the  word  'mind,'  will  by  now  have  clearly 
grasped  that  to  a  large,  learned,  and  ordinarily  sedate 
section  of  the  community  the  very  term  '  the  un- 
conscious mind  '  acts  as  a  real  irritant,  pretty  much 
as  a  red  rag  to  a  bull.  We  may  perhaps  claim  some  von 
slight  merit  here  in  having  steadfastly  refrained,  in 
spite  of  the  greatest  temptation,  from  giving  one  quoted! 
single  quotation  from  Von  Hartmann's  ponderous 
monograph  on  '  The  Unconscious  Mind,'  recognising 
from  past  experience  that  the  very  name  of  the 
distinguished  Professor  is  '  anathema  '  to  the  orthodox 
psychologist.  One  word  more. 

The  author's  Machiavellian  cunning  in  his  choice 
of  a  name  for  this  book  will  by  this  have  become 


44  THE  FOBCE  OF  MIND 

The  title  of  apparent;   as  it  dawns  upon  the  reader  that,  while 

wty00       the  whole  work  is  on  the  powers  of  the  unconscious 

chosen.       mind,  no  hint  of  this   appears  in  the  title,  though 

indeed  it  was  not  easy  to  exclude  it.     The  '  Force  of 

Mind'  as  a  title  is  without  offence;  and  while  the 

*  Mental  Factor'   as  a   substitute  may  give  rise  to 

questions,  it  will  not  prevent  the  purchase  of  the  book 

by  those  who  differ  from  me  with  regard  to  my  view 

of  the  scope  of  mind. 

Are  there          it  is  of  course  still  a  question  in  physiology  if 

two  nervo-       .  ,.  ,  i  •       i  i         1-1    i 

muscular  the  sympathetic  and  cerebro-spmal  nerves  should  be 
classed  as  two  separate  systems ;  and  with  their 
muscles,  smooth  and  striped,  be  designated  respec- 
tively voluntary  and  involuntary  or  not.  As  a  matter 
of  fact,  hardly  a  muscle  in  the  body,  whether  striped 
or  unstriped,  is  under  the  control  of  the  conscious  will, 
while  every  muscle  of  both  systems  is  constantly 
contracted  and  relaxed  at  the  dictates  of  the  uncon- 
scious emotions,  instincts,  &c.,  as  well  as  secondarily 
to  carry  out  some  mandate  of  the  conscious  will. 

And  now,  before  I  proceed  in  the  next  chapter 
to  give  some  illustrations  of  the  action  of  the  un- 
conscious mind  upon  the  body  in  health,  let  me  give, 
if  my  readers  are  not  quite  exhausted,  a  final  picture 
of  what  I  mean  by  a  term  that  has  not  yet  passed 
A  final        into  current  use.     Professor  Lazarus  says  :  we  have 
the  u^n.   first  of  all  to  remember  that  our  psychic  life  is  made 
^*|8         up  of  conscious  and  unconscious  elements.     We  think 
of  consciousness   as   a  brightly  illuminated   sphere 
surrounded  with  widely  extended  darkness,  with  the 
dim    elements,    though    outside   consciousness,    co- 
operating with  those  within  in  a  state  of  co- vibration. 

1  Prof.  Lazarus  in  Mind, '  Das  Leben  der  Seek,'  vii.  599. 


THE  UNITY  OF  MIND  45 

Once,  of  course,  we  admit  that  we  can  have  thoughts 
and  not  be  conscious  of  them,  and  perform  actions 
and  not  be  conscious  of  them,  it  is  evident  that  no 
theory  of  mind  which  does  not  include  the  uncon- 
scious is  adequate ;  unless,  as  is  sometimes  done,  the 
meaning  of  consciousness  is  desperately  stretched  so  as 
to  include  its  opposite,  which  is  of  course  to  destroy 
the  meaning  of  words. 

Our  conscious  mind,  as  compared  with  the  un-  The  con- 
conscious  mind,  has  been  likened  to  the  visible  spec-  mlndag 
trum  of  the  sun's  rays,  as  compared  with  the  invisible  *^ctru 
part  which  stretches  indefinitely  on  either  side.  We 
know  now  that  the  chief  part  of  heat  comes  from  the 
ultra-red  rays  that  show  no  light,  and  the  main  part 
of  the  chemical  changes  in  the  vegetable  world  are 
the  result  of  the  ultra-violet  rays  at  the  other  end  of 
the  spectrum,  which  are  equally  invisible  to  the  eye, 
and  are  only  recognised  by  their  potent  effects. 
Indeed,  as  these  invisible  rays  extend  indefinitely  on 
both  sides  of  the  visible  spectrum,  so  we  may  say  that 
the  mind  includes  not  only  the  visible  or  conscious 
part,  and  what  we  have  termed  the  sub-conscious, 
that  lies  below  or  at  the  red  end,  but  the  supra-con- 
scious mind,  that  lies  beyond  at  the  violet  end — all 
the  regions  of  higher  soul  and  spirit  life,  of  which  we 
are  only  at  times  vaguely  conscious,  but  which  always 
exist  and  contain  our  most  abstract  and  spiritual 
faculties  as  surely  as  the  sub-conscious  links  us  to  the 
body  on  the  other,  both  supra-  and  sub-conscious 
being  parts  of  the  unconscious  mind.  Of  course, 
speaking  of  regions  and  levels  is  merely  figurative, 
the  non-extension  of  mind  being  a  fundamental 
doctrine.  I  would  include  in  the  supra-conscious 


46  THE  FOECE  OF  MIND 

such  a  faculty  as  conscience,  which  is  surely  a  half- 
unconscious  faculty.  Moreover,  the  supra-conscious, 
like  the  sub-conscious,  is  best  apprehended  when  the 
conscious  mind  is  not  active.  Visions,  meditations, 
prayers,  and  even  dreams  have  been  undoubtedly 
occasions  of  the  working  of  the  spirit  apart  from  the 
action  of  reason  or  mind. 

With  this,  then,  I  conclude,  in  the  hope  that  by 
argument  and  quotation  I  have  sufficiently  shown 
that '  as  the  action  of  the  mental  factor  in  disease  is 
unconscious,  it  cannot  be  recognised  as  mental  by 
those  who  limit  mind  to  consciousness,'  and  that 
'  the  word  "  mind  "  must  therefore  be  extended  to 
include  all  psychic  action.' 


CHAPTER  III 
ON  PSYCHO-PHYSIOLOQT 

'The  double  action  of  the  "mental  factor"  on  the 
body  in  health  consists  generally  in  carrying  on  the 
functions  of  life ;  and  specially,  in  physically  expressing 
mental  states.' 

THE  action  of  mind  upon  body  is  at  least  threefold — 
physiological,  pathological,  and  therapeutical.  With  a  mind  on 
little  widening  of  the  word  '  medicine  '  we  may  allow  body< 
our  present  view  of  the  '  mental  factor  '  to  be 
sufficiently  broad  to  include  all  these  three  actions ; 
and  it  is  to  the  first  of  them  that  we  must  now  address 
ourselves.  So  far  I  have  sought,  after  pointing  out 
sufficiently  the  importance  of  my  whole  subject,  to 
show  that  modern  psychological-physiology  demands, 
if  words  are  to  retain  any  definite  meaning,  that  the 
mind  be  declared  one,  whether  conscious  or  un- 
conscious, its  essential  unity  (whatever  its  nature 
may  be)  being  the  possession  of  common  well-marked 
qualities. 

I  may  begin,  then,  our  present  study  with  a  remark 
of  Benjamin  Bush,  made  in  1794,  and  pathetically 
true  to-day.     He  says  :  '  The  extent  of  the  influence  of  Power  of 
the  mind  over  the  body  has  not  yet    been  fully  Kdy°v 
ascertained.'     Still,   although  the  range  of  mental  o*definfd 
action  may  not  be  yet  defined,  and  the    ask  will  not 


48  THE  FORCE  OF  MIND 

be  attempted  here,  there  is  no  doubt  whatever  of  the 
facts  ;  and  to  this  I  now  invite  the  earnest  attention 
of  my  medical  readers.  When  we  once  grasp  the 
interaction  of  mind  and  body  in  health,  we  are  better 
prepared  for  understanding  the  part  they  play  in  disease 
and  cure,  a  part  indeed  of  great  importance  to  the 
practical  physician. 

Professor  Ladd  says  : 1  '  Even  the  most  purely  vege- 
tative of  the  bodily  processes  are  dependent  for  their 
character  upon  antecedent  states  of  the  mind.'     An 
Medical     editorial  in  the  '  Medical  Times  '  in  1872  says  with 
TBimchic0n    mucn  truth  :  '  However  little  we  know  of  the  nature 
force.          of  mind,  or  of  that  form  of  force  to  which  we  give  the 
name  of  mind,  the  effects  capable  of  being  produced  by 
mind   on  body  are  very  clear,  real,  and  considerable, 
and  while  in  all  ages  they  have  been  the  chief  thera- 
peutic agents  on  which  the  charlatan  and  quack  have 
relied,  they  have  probably  been  less  trusted  and  utilised 
by  the  scientific  physician  than  experience  warrants  or 
physiology  or  psychology  suggests.' 

The  The  influence  of  the  unconscious  mind  over  the 

the  D°cly  is  deep,  permanent,  and  all-pervading.  If,  as  I 
believe,  all  the  so-called  automatic  or  reflex  processes 
of  the  body  are  under  the  control  of  this  superior  power 
and  express  its  force,  we  may  clearly  maintain  that  it 
is  not  the  brain  alone,  but  the  whole  body,  that  is  the 
true  organ  of  mind. 

And  yet,  in  spite  of  the  abundant  evidence  of  a 
mental  governing  power,  a  distinguished  physiologist 
recently  writes  that  '  he  knows  nothing  of  any  central 
authority  or  controlling  power  over  the  bodily 
functions.' 

1  Prof.  Ladd,  Physiological  Psychology,  p.  475. 


ON  PSYCHO-PHYSIOLOGY  49 

Some  governing  centre  must  regulate,  control, 
counteract,  guide,  and  arrange  the  action  of  the  human  "necessity 
organism  with  regard  to  the  continual  succession  of 
differing  events,  foods,  surroundings,  and  conditions 
which  are  ever  affecting  it  in  endless  succession  and  in 
constant  varieties,  enabling  it  amid  this  bewildering 
multiplicity  of  changing  influences  to  hold  on  its  steady 
course  of  growth,  health,  nutrition,  and  self-mainte- 
nance with  the  most  marvellous  constancy. 

It  is  sufficiently  clear  also  that  this  governing  Mental  in 
centre  is  essentially  mental  in  nature  and  uncon- 
scious  in  character ;  in  other  words,  that  the  various 
functions  and  organs  of  the  body  are  governed  by 
the  *  unconscious  mind '  through  the  sensori-motor 
mechanism. 

Apart  altogether  from  mere  control,  it  is  wonderful  The 
to  see  how  the  body  and  mind  are  associated  both  in 
sensation  and  motion.  With  regard  to  sensations  of 
various  sorts,  the  interdependence  is  well  known.  For 
instance,  we  connect  many  mental  states  with  definite 
parts  of  the  body — general  felicity  (according  to  Sir 
B.  W.  Richardson)  with  an  active  condition  of  the 
sympathetic  ganglia,  love  with  the  heart,  melancholy 
and  irritability  with  the  liver  ;  while  to  arrive 
at  the  highest  point  of  mental  insight  there  has 
always  been  a  tendency  to  direct  the  thoughts  to  the 
pit  of  the  stomach,  where  lies  the  great  solar  plexus, 
chief  centre  of  the  sympathetic  system.  Here,  too, 
is  the  great  source  of  nightmares,  as  it  is  pressed 
on  by  a  full  stomach  when  lying  in  bed  in  the  dorsal 
position.  Many  other  feelings  are  connected  with 
this  region,  and  we  talk  of  a  sickening  story,  thoughts, 
&c.  The  Bible  and  old  writers  go  lower  still,  and 

•  a 


60  THE  FOKCE  OP   MIND 

speak  of  'bowels  of  mercies,'  being  'straitened  in 
your  own  bowels,'  &c. 

The  With  regard  to  motion  and  the  muscular  system 

j^otion^  generally,  it  is  very  curious  to  see  how  our  body 
expresses  mental  states  in  its  attitude,  carriage,  and 
general  appearance.  If  we  try  to  see  a  thing  with 
our  minds,  we  often  put  an  intense  and  strained 
expression  into  our  eyes.  If  in  a  state  of  delight 
they  become  fixed,  as  on  some  beautiful  vision.  Some 
words,  again,  almost  seem  to  have  pleasant  or  dis- 
agreeable tastes,  and  so  on. 

The  chief  centre  of  the  controlling  power  of  the 
body  is  probably  associated  with  the  cerebral  hemi- 
spheres ;  while  subordinate  centres  are  found  wherever 
there  are  ganglia.    Many  experiments  go  to  show  this. 
Cortex  The  cortex  is  ever  a  special  factor  for  good  or  evil 

controlling   in  the  somatic  life.     Every  organ  and  function  is  re- 
ltre<        presented  there,  and  there  brought  into  vital  unity. 
Professor  Laycock  says  :    '  The  hemispheres,  as  the 
organ  of  thought  and  mental  action  proper,  are  in 
unity  with  all  the  processes  of  life  whatever,  whether 
they  be  termed  vegetative  or  animal.'     The  differ- 
ence in  the  control  of  these  two  mainly  rests  on  the 
fact  that  whereas  the  former  are  ruled  by  the  mind 
unconsciously,  the  latter  are  generally  consciously 
governed.     The  seat  of  the  unity,  therefore,  of  the 
body,  and  to  a  large  extent  of  the  ego,  is  found  in  the 
Bain  and     cortex.     Bain  shows  tha,^  all  tissue  nutrition  is  uncon- 
on  value      sciously  influenced  from  this  great  centre,  and  most 
:tex<     physiological  processes  can  be  arrested  by  its  action. 

It  controls  anabolic  and  katabolic  cell  metabi  lism. 
Professor  Clouston  says : '    '  We  talk  and  laugh  and 

1  Prof.  Clouston,  British  Medical  Journal,  Jan.  18,  1896. 


ON  PSYCHO-PHYSIOLOGY  51 

weep,  we  blush  and  we  shiver,  we  hunger  and  sweat, 
we  digest  and  defaecate  all  through  the  brain  cortex. 
There  is  not  one  of  these  physiological  acts  but  can  be 
instantly  arrested  by  a  mental  act.' 

And  here  we  may  conveniently  pause  a  moment  The 
and  consider  briefly  the  parts  that  conscious  and  un-  'rSSJJ"*" 
conscious  minds  play  in  the  command  of  the  body. 
Before  I  proceed  to  illustrate  this  rule  in  detail  let  us 
outline  in  brief   the   limits  of  the  realm   governed 
directly  by  the  conscious  mind,  and  we  shall  then  see 
clearly  how  very  narrow  they  are  ;    and  if  in  the 
instances  I  shall   adduce   the  power  of  the  mental 
factor  be  admitted,  it  will  be  seen  that  in  almost  every 
case  it  is  the  unconscious  mind  that  acts. 

The  power  to  use  our  lives  through  the  voluntary  we  live 
muscular  and  nervous  systems  appears  to  have  been  SfSS? 
committed  to  our  reason  and  conscious  will-power ;  wuxm- 

sciously. 

while  the  power  to  carry  on  the  processes  of  life  and 
existence  generally  is  under  the  control  of  instinct  or 
unconscious  mental  power.  We  may  be  said  to  live  con- 
sciously and  to  exist  unconsciously.  The  two  powers 
are  variously  exercised  ;  for  while  even  in  health  the 
conscious  mind  often  acts  to  the  detriment  of  the 
body,  the  unconscious  never  does.  The  direct  limits  Power  of 
of  the  conscious  mind  and  will  are  fairly  well  denned,  JSJJJJl 
and  are  generally  pretty  constant;  though  in  some  heart> 
few  individuals  they  extend  much  further  than 
in  the  majority,  but  under  no  circumstances  can 
the  will  produce  any  direct  organic  change  in  the 
body.  With  heart  and  circulation  the  direct  influence 
is  very  small.  By  conscious  effort  in  some  people 
the  heart  can  be  slowed  ;  and  I  believe  there  have 
been  instances  where  it  could  be  arrested.  We  cannot 


52  THE  FOKCE  OF  MIND 

consciously  change  the  volume  and  course  of  the 
circulation. 

Pow«t  In  the  lungs  we  have  greater  power  ;  we  can  con- 

sciously  arrest  the  breathing  altogether  up  to  the 
limits  of  safety.  The  moment,  however,  the  organism 
is  imperilled  for  want  of  oxygen,  a  more  imperious 
power  overcomes  the  strongest  will,  and  we  are  forced 
to  breathe.  We  can  also  vary  the  breathing  at  will 
in  every  conceivable  way,  as  in  singing,  speaking, 

Power  over  yawning,  laughing,  sighing,  &c.  In  the  digestive 
organs  the  conscious  mind  has  only  control  over  the 
commencement  and  termination  of  the  tract,  having 
no  direct  power  whatever  over  all  that  lies  between. 
In  the  mouth  conscious  control  ceases  at  the  fauces, 
or  at  any  rate  with  deglutition.  Up  to  this  point  we 
have  unlimited  powers  -of  choice — beyond  it  none. 
Defaecation  is  under  our  conscious  control,  and  this 
completes  our  powers  over  this  system.  Over  secretion 
we  have  direct  power  in  the  case  of  tears  and  saliva 
only ;  all  the  rest  lie  beyond  the  limits  of  the  will. 

Power  over         0  ver  the  renal  system,  our  only  power  is  in  voluntary 

kidneys.  micturition.  In  reproduction  our  conscious  will  can 
initiate  the  process ;  all  beyond  is  outside  its  power. 
Turning  from  the  vegetative  to  the  animal  systems  : 
over  the  locomotive  powers  we  have  almost  entire 
control,  not  in  their  detailed  actions,  but  in  their 
denned  results.  We  have  perfect  control  in  every 
possible  manner  over  the  movements  that  this  structure 
permits,  over  our  limbs  and  our  tongues ;  though 
all  the  time  absolutely  ignorant  of,  and  powerless  over, 
the  mechanism  that  produces  the  movement. 

In  the  nervous  system  we  have  less  power.     We 
can  use  at  will  portions  of  the  cortex,  and  the  centres 


ON  PSYCHO-PHYSIOLOGY  53 

of  the  special  senses  for  thinking,  speaking,  seeing,  Power  o 
hearing,  smelling,  tasting  and   touching,  &c.      The  nervous 
rest  of  the  brain,  by  far  the  greater  part,  and  all  the  By8tom- 
nerves  of  the  body,  are  beyond  the  direct  conscious 
control  of  the  mind.     We  have  no  power  over  the  skin 
and  its  appendages. 

From  this  brief  summary  it  will  be  seen  that  the 
respiratory,  amongst  the  vegetative  systems,  and  the 
nervous  and  muscular  systems,  are  the  three  over 
which  the  will  has  a  large  range  of  power,  while  over 
the  rest  its  control  is  very  small. 

Wherever  the  conscious  limits  are  reached  there  Where 
the  powers  of  the  unconscious  mind  begin,  and  its 
actions,  though  only  styled  instinctive,  may  be  truly 
said  to  be  on  the  whole  far  more  rational  and  bene- 
ficial than  those  inspired  by  what  is  always  assumed 
to  be  reason,  but  which  just  as  often  is  unreason, 
and,  indeed,  becomes  at  times  a  positive  power  for  evil 
over  the  body ;  a  disaster  which  rarely  happens  in 
the  case  of  the  unconscious  mind.     We  think  we  live  Our  reason 
entirely  as  reasonable  beings,  but  it  is  very  rarely  that  would  not 
we  do,  and  none  of  us  could  exist  for  a  day  were  we  fJJ^iy. 
not  guarded  and  guided  incessantly  by  a  never-erring 
instinct. 

Hack  Tuke's  classic  work  on  the  connection  of  mind  ?j£llect 
and  body  divides  the  action  of  the  mind  into  that  emotious, 
produced  by  intellect,  emotion,  and  will ;  and  out  of 
the  whole  number  of  special  instances  given  we  find 
that  36  %  are  du«  to  the  intellect,  56  %  to  the  emo- 
tions, and  8  %  to  the  will.     He  points  out  that  the 
intellect  appears   to  influence  the  vascular  tissues 
most ;  emotion  the  glands  and  organs,  specially  the 
heart ;  and  the  will  the  so-called  voluntary  muscles. 


54  THE  FORCE  OP  MIND 

LO^J         Some  emotions,  he  adds,  act  specially  on  definite 

expression    organs — as  grief  on  the  lachrymal  gland  ;  some  in 

certain  regions,  as  shown  in  the  skin  of  the  face  ;  and 

some  more  on  the  voluntary  muscles — as  wonder  on 

the  facial  muscles. 

Unoon-  We  may  now  very  briefly  consider  the  mental 

miulTand  factor  in  various  simple  physiological  processes,  as 
the  heart.  producing  Or  arresting  them  under  certain  special 
conditions,  as  well  as  in  its  general  controlling  power. 
With  regard  to  the  heart,  we  all  know  that  of  all  organs 
in  the  body  it  is  the  one  most  swayed  by  the  mind 
and  emotions.  In  all  people  the  mind  can  alter  its 
movements  in  speed,  rhythm,  and  force ;  but  in 
nervous  people  it  is  a  veritable  echo  of  the  prevailing 
emotion  at  the  time.  The  emotion  may  be  strong 
enough  to  produce  what  amounts  to  pathological  action. 
'I  have  never  met,'  says  Sir  B.  W.  Eichardson, 
1  with  a  case  of  intermittent  pulse  that  was  not  due 
to  some  mental  cause — shock,  fear,  sorrow,  &c.'  This 
may,  in  Sir  B.  W.  Eichardson's  experience,  be  so,  but 
the  present  writer  has  seen  more  than  one  case  due 
Uncon-  apparently  to  the  circulation  of  uric  acid  in  the  blood, 
JJriJaVaa  though  at  the  same  time  there  is  no  doubt  that 
the  circu-  emotion  is  a  most  potent  factor,  even  if  not  a  constant 
cause.  Look  at  the  vascular  system ;  not  in  microsco- 
pical, chemical,  and  mechanical  detail,  as  so  admirably 
set  forth  in  our  physiologies,  but  as  it  acts  in  man, 
intelligently  directed  for  the  benefit  of  the  whole  being. 
The  circulation  does  not  go  round,  as  most  text- 
books would  lead  us  to  believe,  as  the  lesult  merely 
of  the  action  of  a  system  of  elastic  tubes,  connected 
with  a  self-acting  force-pump.  It  is  such  views  as 
these  that  degrade  physiology  and  obscure  the  marvels 


ON  PSYCHO-PHYSIOLOGY  66 

of  the  body.  The  circulation  never  flows  for  two 
minutes  in  the  same  manner.  In  an  instant,  miles 
of  capillaries  are  closed  or  opened  up  according  to  the 
ever- varying  body  needs,  of  which,  consciously,  we  are 
entirely  unaware.  The  blood  supply  of  each  organ 
is  not  mechanical,  but  is  carefully  regulated  from 
minute  to  minute  in  health  exactly  according  to  its 
wants  and  activities,  and  when  this  active  control  ever 
fails,  we  at  once  recognise  it  as  disease,  and  call  it 
congestion  and  so  forth. 

The  circulation  and  heart  form  an  organic  entity  Unoon. 
carrying   on,  under  some   diligent   supervision    (the  m^and 
unconscious  mind),  purposive  and  ever- varying  action  JJjjJj^ 
for  the  good  of  the  body  as  an  organic  unity,  as  well 
as  subordinately  for  itself,  as  a  part  of  that  unity. 

The  calibres  of  arterioles  and  capillaries  are  ever 
changing  throughout  their  countless  miles,  and  the 
beat  of  the  heart  alters  incessantly.  To  call  all  this 
action  of  the  vaso-motor  and  pneumogastric  and  other 
nerves  merely  reflex,  in  the  sense  that  governor-balls 
flying  round  regulate  the  speed  of  an  engine  in  pro- 
portion to  its  work,  is  inadequate  and  inexact.  We 
doubt  not  that  much  may  be  of  this  character ;  but 
the  circumstances  in  which  the  body  is  placed  are 
constantly  unique,  novel,  and  unanticipated,  and  of  a 
nature  that  no  mere  mechanical  arrangements  could 
meet,  and  we  may  add  no  mechanical  automaton 
survive.  Consider  what  adjustments  of  the  vascular  incessant 
system,  and  especially  the  surface  capillaries,  are  needed?611 
needed  for  incessant  changes  of  temperature,  for 
changes  of  position  and  gravity,  for  changes  of  time, 
as  at  night  to  secure  sleep,  for  the  varying  activities 
of  each  organ,  for  special  supplies  to  the  stomach  at 


56  THE  FOECB  OF  MIND 

lunch  and  dinner,  and  to  the  brain  when  reading 
these  pages,  for  blanching  and  blushing  with  various 
emotions,  for  supplies  to  the  limb  muscles  in  active 
exercise,  for  eliminating  poisons  from  the  blood,  and  for 
the  reception  of  food  and  the  functions  of  metabolism. 
Fear  can  close  in  a  moment  miles  of  capillary  vessels, 
which  shame  can  as  quickly  open.  With  regard  to 
blushing,  one  or  two  points  are  of  interest. 
Blushing.  It  is  believed  that  no  animals  can  blush  ;  children 
of  three  years  old  can.  The  limits  of  blushing  rarely 
extend  as  low  as  the  clavicles  in  front  and  the  scapulae 
behind ;  but  one  instance  is  recorded  of  the  whole 
body  blushing  from  shame.  The  other  day  I  had 
a  nerve  patient  whose  heart  I  wished  to  examine.  As 
she  uncovered  the  chest  I  perceived  a  scarlet  rash 
extending  as  low  as  the  middle  of  the  bosom.  I  found 
that  she  habitually  blushed  to  this  level. 
Uncon-  The  digestive  organs  in  the  same  manner  must 

mlnTaud  be  centrally  controlled  to  respond  in  the  marvellous 
digestion.  manner  they  do  to  the  endless  variation  and  quantity  of 
food,  consisting  often  of  new  and  untried  ingredients, 
and  received  at  most  irregular  intervals.  All  the 
supplies  of  the  various  digestive  fluids  have  to  be  made 
in  the  required  amounts  and  at  definite  times.  The 
mechanism  of  the  liver  has  ever  to  be  readjusted  to 
its  work  of  incredible  delicacy.  Poisons,  excess,  and 
starvation,  and  the  needs  of  all  the  other  organs 
require  to  be  met  from  day  to  day. 

Examples.  Besides  all  this,  special  mental  states  also  produce 
special  physical  results.  Benjamin  Bush  pointed 
out  in  1774  that  thirst  without  any  physical  cause 
was  common  at  the  beginning  of  a  battle  from  mental 
emotion.  The  thought  of  an  acid  fruit  will  fill  the 


ON  PSYCHO-PHYSIOLOGY  57 

mouth  with  water  ;  hence  a  successful  way  of  stopping 
discordant  street  noises  is  to  suck  a  lemon  within 
full  view  of  a  German  band.  Fear,  on  the  other 
hand,  will  so  dry  the  throat  that  raw  rice  cannot  be 
swallowed.  This  is  a  test  in  India  for  the  detection 
of  a  murderer.  The  suspected  man  is  brought 
forward,  and  given  a  handful  of  dry  rice  to  swallow. 
If  he  is  innocent  he  can  probably  do  this  ;  if  he  is 
guilty  he  positively  cannot,  fear  having  completely 
dried  his  mouth. 

With  regard  to  the  stomach,  apart  from  actual 
disease,  we  may  notice  one  or  two  instances  of  un- 
conscious  mind  action.  A  passenger  on  a  Channel 
steamer  who  was  very  seasick  lost  a  valuable  set  of 
artificial  teeth  overboard,  and  was  instantly  cured. 
If  the  thoughts  are  strongly  directed  to  the  intestinal 
canal,  as  by  bread  pills,  strong  peristaltic  action  may 
ensue.  Vomiting  occurs  from  mental  causes  apart 
from  injury  to  the  brain.  Bad  news  will  produce 
nausea ;  and  severe  nerve  shock  may  absolutely  cause 
vomiting.  Certain  emotions,  the  sight  of  vomiting, 
certain  smells,  or  thoughts  about  a  sea  voyage,  or  the 
idea  that  an  emetic  has  been  taken,  may  also  produce 
nausea  or  vomiting. 

The  mere  thought  of  food,  even  without  the  smell 
or  sight  of  it,  can  produce  a  copious  flow  of  saliva  in 
the  mouth,  as  well  as  of  gastric  juice  into  the  stomach. 
The  bowels  are  largely  under  the  control  of  the 
emotions,  as  also  the  action  of  the  kidneys — a  fact 
well  known  to  students  at  examinations. 

The  respiratory  system  is  closely  responsive  to 
the  mind.      The    breathing   may  incessantly   vary  miud  and 
according  to  the   amount   of   oxygen  respired   from  reBPiration- 


58  THE  FOBCE  OF  MIND 

different  qualities  of  air,  from  the  activity  of  the 
body,  from  the  rate  of  the  interchange  of  gases,  from 
the  amount  of  the  action  of  skin  and  kidneys ;  from 
the  needs  of  the  body  according  to  posture,  condition, 
and  state  of  the  heart  and  circulation,  &c. 

And  all  this  has  to  be  regulated  with  such  nicety, 
and  in  circumstances  of  such  endless  variety,  that 
eensori-motor  reflexes  alone  can  hardly  account  for  it. 
Laughing,  speaking,  sighing,  and  other  respiratory 
acts  are  of  course  direct  expressions  of  mind ;  but 
breathing,  yawning,  coughing,  are  also  continually 
altered,  arrested,  or  produced  by  mental  states. 

The  short  quiet  breath  of  joy  contrasts  with  the 
long  sigh  of  relief  after  breathless  suspense.  Joy  gives 
eupncea,  or  easy  breathing ;  grief,  or  rather  fear,  tends 
to  dyspnoaa,  or  difficult  breathing.  Sobbing  goes 
with  grief,  laughter  with  joy,  and  one  often  merges 
into  the  other. 

The  on-  Dr.  Morton  Prince  says  '  a  lady  whom  he  knew 

^Snd     alwavs  nad  a  violent  catarrh  in  the  nose  (hay  fever)  if  a 

hay  fever,    rose  was  in  the  room.     He  gave  her  an  artificial  rose, 

and  the  usual  symptoms  followed.    He  then  showed 

her  it  was  made  of  paper,  had  no  pollen,  &c.,  and 

ever  after  all  symptoms  disappeared. 

Unoon-  ^e  muscular  system  is  under  the  direct  control 

scions         of   the   unconscious   mind,   and   under  the   indirect 

SlTsci^      control  of  the  conscious  mind,  as  far  as  the  striped 

generally.    muscies  ^he  heart  excepted)  are  concerned.     In  the 

voluntary  muscles   the  most  we  can   do   is   to  will 

results.     We  cannot  consciously  will  the  contractions 

that  carry  out  these  results,  these  being  produced  by  the 

1  Dr.  Morton  Prince,  Journal  of  Nervous  and  Mental  Diseases. 
(Boston,  May  1891.) 


ON  PSYCHO-PHYSIOLOGY  59 

unconscious  mind.  Moreover,  while  all  the  muscles 
can  be  influenced  by  the  emotions,  only  the  '  voluntary 
muscles  can  be  moved  by  the  will.1 

Vertigo,  experienced  at  the  mere  apprehension  of  Vertigo 
danger,  is  an  instance  of  the  disturbance  of  muscular  balancing, 
co-ordination  by  a  thought.  On  the  other  hand, 
sudden  and  unconscious  balancing  in  climbing  up  and 
down  a  mountain,  done  with  perfect  ease  if  performed 
unconsciously,  but  with  much  awkwardness  by  con- 
scious will,  is  an  illustration  of  mental  control  of  the 
muscles.  The  jar  from  the  idea  that  a  step  less  or 
more  exists  when  going  downstairs  shows  how  perfect 
the  unconscious  adjustment  of  the  body  is,  and  how 
disastrous  any  interference  may  be.  Moreover,  while 
all  the  muscles  can  be  influenced  by  the  emotions, 
only  the  voluntary  muscles  can  be  moved  by  the  will. 

This  is  a  very  interesting  and,  we  think,  accurate  striped 
distinction  between   the    action  of  striped   and   un-  striped" 
striped  muscles.     It  would  appear  that  the  difference  musclea- 
arises  because  emotions    (unconsciously)  can  act  on 
the  body  through  both  the  sympathetic  and  cerebro- 
spinal  nervous  systems  ;  whereas  conscious  wills  can 
only  affect  the  cerebro-spinal,  and  even  this  by  means 
of  the  unconscious  mind. 

The  voluntary  muscles  may  be  moved  quite  un-  Unoon- 
consciously  by  emotion.     The  stump  of  Nelson's  arm 
shook  uncontrollably  at  Trafalgar  from  mental  causes. 

Voluntary  power  over  muscles  may  be  compara- 
tively lost  (paralysis),  and  yet  emotion  may  move 
them  through  the  unconscious  mind. 

The  voluntary  muscles  of  the  body  are  continually 
being  moved  by  unconscious  mental  action,  as  in  the 
expression  of  the  face,  the  varying  attitudes  of  the 


60  THE  FOECE  OF  MIND 

body  corresponding  to  mental  states  which  we  have 
noted. 

Artists  well        Artists  well  know  the  power  of  the  unconscious 

value  of6     mind  over  voluntary  muscles.     If  a  model  attempts 

consd^us     consciously  to  arrange  his  hand  or  arm  in  a  graceful 

mind.         position,  it  becomes  hopelessly  stiff.     He  must  just 

let  it  fall  naturally,  and  it  at  once  harmonises  and 

composes  with  the  face.     The  same  mind  must  move 

the  hand  and  face.     Again,  a  model  must  be  engaged 

in  conversation  to  lose  the  consciousness  that  he  is 

'  sitting.'  The  facial  muscles  are  then  at  once  arranged 

by  his  unconscious  mind  on  the  lines  of  his  character ; 

and   the    artist  gets  what   he  calls  a  characteristic 

expression. 

So  all  through,  everything  that  is  unconscious  hi 
muscular  action  is  '  natural,'  and  everything  done  in 
self-consciousness  tends  to  conceal  or  distort,  rather 
than  to  represent  the  man. 

Uncon-  Consider  also  the  marvellous  increase  of  smooth 

muscle  in  the  uterus  at  term  and  its  no  less  marvellous 
subsequent  involution  ;  observe,  too,  the  compensating 
muscular  increase  of  a  damaged  heart  until  the 
balance  is  restored,  and  then  its  cessation ;  consider 
the  growth  of  the  body  and  its  arrest  at  a  fixed  period. 
Also  the  detailed  process  of  repair  in  a  broken  bone, 
and  for  a  damaged  lung.  These  actions  do  not  pro- 
ceed from  any  inherent  properties  of  matter,  nor  are 
they  the  result  of  ingenious  mechanism.  They  de- 
mand, and  are  the  product  of,  a  controlling,  and  yet 
an  unconscious  mind. 

Consciousness,  indeed,  only  hinders  some  of  these 
actions.  Somnambulists  can  balance  themselves  in 
dangerous  positions  unconsciously,  which  they  could 


ON  PSYCHO-PHYSIOLOGY  61 

not  maintain  for  a  moment  were  they  awake.   Hypno- 
tised subjects  can  assume  attitudes  and  perform  feats 
impossible  to  their  conscious  powers.     The  organic  or  Uncon- 
vegetative  functions,  as  well  as  the  skin  and  hair,  are 
specially  affected  by  the  emotions.     Fear  and  other  ^£<and 
mental  influences  can  not  only  alter  the  circulation 
in  the  skin,  but  can  produce  copious  perspiration,  and 
even  certain  skin  eruptions.  The  hair  can  be  blanched 
and  can   also  fall  out  under   the  influence  of   the 
mind. 

But  the  most  remarkable  instances  of  skin  changes  stigmata, 
through  the  mind  are  the  stigmata,  some  cases  of 
which  appear  to  have  been  verified  and  to  be  authentic. 
This  is  of  course  caused  by  an  interference  with  circu- 
lation ;  but  we  class  them  with  skin  changes,  as  they 
are  evidenced  there.  The  first  historic  instance  is 
that  of  St.  Francis  of  Assisi  on  September  15,  1224 ; 
and  the  facts  appear  to  be  vouched  for  by  reliable 
biographers.  Since  then  there  are  about  ninety  more 
or  less  authenticated  cases ;  eighteen  being  males  and 
seventy-two  females.  Louise  Lateau  is  a  compara- 
tively recent  instance.  Some  remarks  of  Professor 
Barrett's  on  the  subject  are  worth  reproducing  here. 
He  says : l  *  It  is  not  so  well  known,  but  it  is  neverthe-  gjjJ^J0' 
less  the  fact,  that  utterly  startling  physiological  on  their 
changes  can  be  produced  in  a  hypnotised  subject 
merely  by  conscious  or  unconscious  mental  suggestion. 
Thus  a  red  scar  or  a  painful  burn,  or  even  a  figure  of 
a  definite  shape,  such  as  a  cross  or  an  initial,  can  be 
caused  to  appear  on  the  body  of  the  entranced  subject 
solely  through  suggesting  the  idea.  By  creating  some 
local  disturbance  of  the  blood-vessels  in  the  skin,  the 

1  Prof.  Barrett  (Prof.  Physics,  T.C.D.),  Humanitarian,  1895. 


62  THE  FOECE  OF  MIND 

unconscious  self  has  done  what  it  would  be  impossible 
for  the  conscious  self  to  perform.  And  so  in  the  well- 
attested  cases  of  stigmata  where  a  close  resemblance 
to  the  wounds  on  the  body  of  the  crucified  Saviour 
appears  on  the  body  of  the  ecstatic.  This  is  a  case  of 
unconscious  ^/-suggestion,  arising  from  the  intent 
and  adoring  gaze  of  the  ecstatic  upon  the  bleeding 
figure  on  the  crucifix.  With  the  abeyance  of  the  con- 
scious self,  the  hidden  powers  emerge,  whilst  the 
trance  and  mimicry  of  the  wounds  are  strictly  parallel 
to  the  experimental  cases  previously  referred  to.  May 
not  some  of  the  well-known  cases  of  mimicry  in 
animal  life  originate,  like  the  stigmata,  in  a  reflex 
action,  as  physiologists  would  say,  below  the  level  of 
consciousness,  created  by  a  predominant  impression 
analogous  to  those  producing  the  stigmata  ?  That  is 
to  say,  to  reflex  actions  excited  by  an  unconscious 
suggestion  derived  from  the  environment ;  in  other 
words,  the  dynamic,  externalising  power  of  thought, 
if  the  action  of  that  which  is  unconscious  may  be 
called  thought.  We  must,  in  fact,  extend  our  idea  of 
"  thought "  to  something  much  wider  than  intellection 
or  ideation— these  are  special  acts  of  thought,  for  the 
directing  functional  activity  of  our  sub-liminal  life 
has  also  the  attributes  of  thought  though  we  may  be 
unconscious  of  its  thinking.' 

Uncon-  The   general    appearance  of  a  man  is  largely  a 

mLAnd     physical  expression  of  his  mind,  and  his  character  is 

aspect8*      more  or  less  legibly  stamped  upon  the  body.     The 

state  of  the  mind  unconsciously  alters  the  poise  of  the 

head,  of  the  shoulders,  arms  and  legs,  and  trunk.     A 

short  time  of  trouble  may  make  a  man  look  many 

years  older  than  before  it  commenced.    The  eye  will 


ON  PSYCHO-PHYSIOLOGY  63 

lose  its  brightness,  the  face  will  becoma  withered,  the 
brow  wrinkled,  and  the  skin  harsh. 

With  regard  to  sensation  generally,  Hack  Take  l  Speoui 
asserts  '  that  there  is  no  sensation— general  or  special  J^8ral 
— excited  by  agents  acting  upon  the  body  from  with-  £6us»tioi> 
out,  which  cannot  also  be   excited    from  within  by  Aroused 
emotional  states  affecting  the  sensory  centres.'  abnormal 

We  must  remember  that  though  tha  asual  exciting  mean8- 
causes  of  sight,  sound,  or  common  sensation  are 
thought  to  be  unusual,  they  are  not  so  j  and  in  their 
absence  sight,  sound,  and  sensation  may  all  be  con- 
sciously experienced.  Common  and  special  sensations 
may  indubitably  be  aroused  by  abnormal  physical 
means  as  well  as  by  purely  mental  agencies.  Pressure 
on  the  nerves  from  a  tumour  or  a  blow  will  illustrate 
the  former  case  and  vivid  ideas  the  latter. 

The  illustrations  of  the  action  of  mind  on  sight  fc'noon- 
are  literally  innumerable.     I  will  give  but  one  or  two.  SaYnd 

Professor  Binet  tells  us  of  a  Dr.  A.,  who,  with  aight 
his  mind  full  of  an  examination  on  botany,  walked 
past  a  restaurant  and  saw  on  the  door  *  Verbascum 
thapsus.' 

He  turned  back  astonished  and  read  the  real  word 
*  Bouillon.'  The  error  in  vision  was  due  to  the  fact 
that  '  bouillon  blanc '  is  the  common  name  for 
'  Mullein  '  or  '  Verbascum  thapsus/  and  an  uncon- 
scious connection  was  instantaneously  formed  in  his 
mind  between  the  two. 

The  following  is  headed  '  An  Anxious  Sportsman  ' 
in  the  '  Daily  Telegraph '  of  September  8,  1896.  A 
boy  having  fired  at  a  bird  rising  nearly  just  behind 
his  father,  the  father  writes  : 

•  Haok  Tuke,  Mind  and  Body. 

P 


64  THE  FORCE  OP  MIND 

'I  remarked  to  him  afterwards  that  I  quite 
expected  him  to  injure  me,  and  mentioned  the 
particular  instance.'  His  reply  was,  '  I  never  even 
saw  you.'  The  boy,  no  doubt,  was  so  keen  on 
bagging  his  bird,  that  he  really  did  not  see  the 
father. 

In  looking  through  a  microscope  where  attention 
is  given  to  the  object,  the  other  eye  can  be  open  with- 
out seeing  anything,  all  messages  from  it  being  in- 
hibited before  they  reach  consciousness,  as  completely 
as  if  the  eye  were  shut. 

There  is  no  doubt  that  the  protective  mechanism 
of  the  eye  that  consists  hi  the  sudden  closure  of  the 
eyelids,  starting  back  involuntarily  and  raising  the 
arms  in  defence,  is  directly  controlled  and  co-ordinated 
by  the  unconscious  mind. 

Uncon-  Turning  to  hearing,  we  see  how  the  mind  affects 

minTana     tne  auditory  impressions. 

hearing.  Some  years  ago,  when  constantly  called  out  at  night, 

I  frequently  heard,  as  I  thought,  the  night-bell  ring 
distinctly.  On  going  down  I  found  it  had  not  been 
rung.  After  long  practice  I  could  still  only  dis- 
tinguish doubtfully  between  the  real  bell,  the  sound 
of  which  was  a  little  more  vivid,  and  the  imagi- 
nary. 

I  had  for  some  months  a  clever  trained  nurse  with 
a  patient  who  kept  shouting  loudly  at  her.  In  taking 
her  exercise  alone  out  of  doors  she  constantly  heard 
the  patient  speaking  to  her. 

'  The  ear,'  says  Tuke,  '  often  responds  to  well- 
known  sounds  when  it  does  not  to  others.  A  distin- 
guished oculist  could  not  possibly  be  roused  from  his 
sleep  until  a  friend  whispered  in  his  ear,  "  I  have  a 


ON  PSYCHO-PHYSIOLOGY  65 

foreign  body  in  my  eye ;  can  you  remove  it  ?  "     The 
effect  was  electrical.' 

The  mind  alters  taste.  A  man  sent  the  cream 
away  because  it  was  sour,  but  found  it  sweet  when 
the  servant  brought  it  in  again — he  imagining  it  was  t&8te> 

,        i  ,  touch,  and 

a  fresh  supply.  8meu. 

As  to  touch.  Dr.  Pearson,  when  he  first  took  up 
a  globule  of  potassium  and  was  told  it  was  a  metal, 
exclaimed,  '  Bless  me  !  how  heavy  it  is  ! '  simply  from 
expecting  it  to  be  so,  whereas  it  is  excessively  light. 

As  to  smell.  '  Professor  Bennett  tells  us  of  a 
Scotch  procurator-fiscal,'  says  Tuke,  '  who,  on  having 
to  exhume  a  body,  declared  when  the  coffin  appeared 
that  he  perceived  a  strong  odour  of  decomposition, 
which  made  him  so  faint  he  had  to  leave.  On  opening 
the  coffin  it  was  found  to  be  empty.' 

I  doubt  not  that   many  of  the  instances   given  psychi0 
will  be  at  once  dismissed  as  sensori-motor  reflexes.  fne™^Jri. 
It  may  be  that  they  are  so  ;  but  this  merely  leads  the  motor 
inquiry  one  step  further  to  a  question  as   yet  un- 
decided as  to  the  true  nature  of  a  so-called  reflex,  and 
as  to  whether  after  all  there  is  not  some  psychical 
element   acting   in   the  latent  time   that  has   been 
so  much  noted  recently  in  the  sensori-motor  action, 
between  the  arrival  of  the  impulse  and  the  ensuing 
motion.     Still,  setting  aside  those  cases  deemed   of 
doubtful  value  by  the  critical  reader,  I  would  ask,  Is 
there  not  abundant  evidence  left  of  the  control  the 
mind  unconsciously  exercises  over  the  body  in  health, 
both  generally  and  specially,  so  as  to  establish  the 
thesis  at  the  head  of  our  chapter  ? 

The  conscious  mind  has,  as  we  all  admit,  no 
direct  control  over  the  vital  functions  of  the  body,  and 


66  THE  FOKCE  OF  MIND 

Evidence  only  in  a  general  way  over  even  the  'voluntary 
muscles  ; '  but  is  there  not  clearly  some  power,  mental 
an(*  Purposive  in  character,  that  harmoniously  co- 
ordinates  and  regulates  them  all  for  the  common 
weal?  If  it  be  so,  is  not  the  term  'unconscious 

Not      t      mind  '  altogether  more  rational  and  intelligible  than 

'Physio-  such  words  as  'Nature,  Physiology,'  &c.,  which  are 
in  general  use,  and  after  all  mean  nothing  ? 

Conciu-  I  conclude,  then,  this  fragmentary  sketch  of  the 

physiological  action  of  this  Psychic  Force,  and  trust 
I  have  said  enough  to  indicate  that  '  the  double 
action  of  the  "  mental  factor  "  on  the  body  in  health 
consists  generally  in  carrying  on  the  functions  of 
life;  and  specially  in  physically  expressing  mental 
states.' 


CHAPTER  IV 
ON  PSYCHO-PATHOLOGY 

'  The  mental  factor  is  present  in  some  way  or  other 
in  all  diseases.' 

WE  now  reach  the  second  of  the  three  actions  of  the 
mind  upon  the  body,  that  I  indicated  in  the  last  of 
chapter.  The  first  treated  of  there  was  Psycho- 
physiology  ;  the  two  remaining  are  Psycho-pathology 
and  Psycho-therapeutics.  I  don't  know  that  there  is 
much  use  in  this  incessant  compounding  of  words, 
but  it  is  the  fashion,  and  they  are  undoubtedly 
expressive,  if  not  euphonious. 

In  turning  to  the  mind  in  pathology,  we  reach  a  A  general 
subject  that  cannot  be  handled  in  a  single  chapter,  subject. 
I  can  but  attempt  to   give  a  very  general    view  of 
the  matter,  leaving  the  connection  of  the  mind  with 
special   diseases   and   also  with  the  entire  class  of 
functional  nerve  diseases  for  future  treatment. 

I  will  now  therefore  consider  the  general  relation 
of  the  mind  to  disease,  both  organic  and  functional, 
as  a  causal  factor.  It  is  no  doubt  possible,  and 
most  probable,  that  these  two  terms  are  clinical  rather 
than  scientific ;  and  that  no  great  value  must  be 
attached  to  them.  But  those  who  feel  this,  must 
remember  that  very  much  of  our  language  is  more 


88  THE  FOECB  OF  MIND 

Langnage    expressive  of  our  ignorance  than  of  our  knowledge, 
reveals  our  And   ^18  no^   al°ne   ^n  common   parlance,   but   in 
ignorance.    medical  phraseology ;  and,  to  carry  the  matter  one  step 
further,  even  in  science  itself.     What  do  the  words 
'  atoms,'  '  affinities,'  '  combining  bonds,'  really  mean  ? 
The  very  expressions '  mental '  and '  physical '  may,  after 
all,  yet  prove  to  be  but  two  aspects  of  the  same  thing. 
Differences         Most  of  our  distinctions  are  due  to  the  imperfection 
fictitious,     of  our  vision,  or  to  the  limitation  of  our  conceptions  ; 
and  when   very  closely   looked   into,  the   difference 
between  organic  and  functional  tends  to  disappear ; 
and,  as  a  matter  of  fact,  we  are  brought  to  this,  that 
Functional  no  change  in  function,  as  well  as  no  action  of  mind, 
organic  go    can  ever   take    place  without    some    corresponding 
together,     physical  alteration   of  structure.     While  freely  ad- 
mitting this,  however,  we  retain  the  terms  as  none 
the  less  useful  because  they  are  not  scientific  ;  under- 
standing   organic    disease    to     mean     that    disease 
where  the  physical  changes  are  gross  and  obvious,  and 
functional  disease  that  where  they  are  neither. 

tiongtoebe  ^^  now'  ^  ^00^^n8  at  tne  bearing  of  mind  upon 

avoided.      these  two,  and  first  upon  the  organic,  let  us  at  the 

outset  guard  against  any  appearance  of  exaggeration. 

It  is  of  course  difficult  to  preserve  a  right  sense  of 

proportion  when  dealing  exclusively  with  what,  after 

all,  is  but  a  small  part  of  a  very  great  subject.     In 

treating  of  the  mental  factor  in  disease,  therefore, 

to  the  exclusion  of  all  others,  one  is  apt  to  fall  into 

the  same  error  as  our  leading  railway  companies  do  in 

their  respective  maps. 

SSS*1 "          *n  t^iese  well-known  works  of  fiction  they  seem  to 

m»P«.         find  it  impossible  to  resist  the  temptation  of  depicting 

their  own  railway  as  leading  in  straight  lines  every- 


ON  PSYCHO-PATHOLOGY  69 

where,  while  their   rivals   are  indicated   by  narrow 
tortuous  wriggles  that  appear  to  lead  nowhere. 

Lest,  therefore,  it   should   be  thought  that  the 
necessary   prominence  given  to  a   single  factor  of 
disease  in  a  work  exclusively  devoted  to  it  represents 
its  real  place  in  medicine,  let  me  say  '  right  here  '  (as 
our  American  cousins  would  put  it)  that,  with  the 
exception  of  mental  and  functional  nerve  diseases, 
the  part  that  the  mental  factor  plays  is  exceedingly  Mental 
small,  and   often   very  obscure  and  ill  denned.     It  pkyToniy 
would  be  as  ridiculous  to  suppose  for  a  moment  that  J^SaU 
the  aetiologies  of  disease  given  in  leading  text-books 
do  not  describe  correctly  the  main  causes,  predisposing 
and  exciting,  of  the  various  affections,  as  it  would  be 
incorrect  to  assert  that  they  can  possibly  enumerate 
them  all,  when  the  mental  factor  is  omitted.     For,  stm, 
though  small,  it  is  certainly  a  constant  contributing  snuai,  it  i> 
cause  in  organic  disease  somewhere  in  its  course,  and  ubl^mt°0ii 
often  all  through.     It  may  be  a  predisposing  cause, 
an  exciting  cause,  an   aggravating  or  a  modifying 
accompaniment ;   it  may  act  as  a  poison,  or  thera- 
peutically  as   a  medicine.     What   is  of   importance 
is  not  therefore  its  size  but  its  ubiquity ;  and  this, 
coupled  with  its  general  neglect,  may  be  a  sufficient 
apology  for  bringing  it  forward  with  such  prominence 
in  these  pages. 

The  influence  of  the  mind  in  all  forms  of  func-  JJjJjj^ 
tional  nerve  disease  is  generally,  though  by  no  means  nerve 
universally,    admitted.      And  this  want  of    unani-  noTaiwayi 
mity  need  occasion  no   surprise  when  we  find  that  admitted- 
there  are  those  who  refuse  to  recognise  the  mind  as 
a  cause  even  in  mental  diseases. 

On  the  other  hand,  a  large  number  who  freely 


70  THE  FORCE  OF  MIND 

what  is      admit  the  mental  factor  in  mental  and  in  functional 

l?ganic       nerve  diseases  firmly  declare  that  it  has  no  part  in 

disease'  v     <  purely  organic  disease,'  whatever  that  may  mean.    To 

us  the  phrase  is  obscure,  for  if  functional  disease  may 

after  all  be  organic  at  the  bottom,  a  fortiori  there 

can  be  no  organic  disease  without  some  derangement 

of  function. 

It  may  not  be  needful  here  again  to  insist  on  the 
importance  of  the  knowledge  of  all  the  parts  mind 
plays  hi  disease,  for  we  are  at  present  only  concerned 
with  its  share  in  aetiology.  Later  on,  when  I  come  to 
treatment  and  therapeutics,  where  its  power  is  so 
obvious  and  so  great,  and  yet  so  set  aside,  I  may 
enlarge  upon  the  practical  power  that  this  knowledge 
in  the  art  of  medicine  gives. 

si,  P.  Sir  Francis  Bacon  observes  T  that '  the  knowledge 

mindnand     concerning   the    sympathies    and    the    concordances 
body-          between  the  mind  and  the  body  is  fit  to  be  made  a 
knowledge  of  itself.' 

The  '  British  Medical  Journal,'  after  all,  may  be 
right  when  it  speaks2  of  the  difficulty  of  acquiring 
this  knowledge  as  being  the  real  deterrent.  And 
coupled  with  this  there  is  doubtless  everywhere  a 
tendency  in  partially  trained  minds  to  doubt  or 
reject  somewhat  too  readily  what  cannot  be  easily 
proved  by  eyes  and  ears. 

It  would  seem  that  a  science  that  regards  the 

senses  as   the   sole  source  of  truth  is   as  far  from 

being  correct  as  the    (Christian)  science  (so  called) 

that  considers  the  senses  the  source  of  all  error. 

When  we  can  learn  equally  to  appreciate  all  the 

1  Sir  Francis  Bacon,  Advancement  of  Learning,  ii.  sect.  iz. 
1  See  su/pra,  Chapter  I.  p.  11. 


ON  PSYCHO-PATHOLOGY  71 

sources  of  knowledge,  and  when  the  philosopher  and  The  golden 
scientist  can  '  lie  down '  together,  the  golden  age  of  Som. 
wisdom  will  have  dawned  on  man. 

Before  enumerating  various  organic  and  other 
diseases  where  the  mental  factor  can  be  more  or  less 
clearly  traced,  we  will  give  a  few  extracts  from  some 
leading  writers  on  the  relation  of  mind  to  disease  as  a 
whole. 

Sir  James  Paget  speaks  as  follows  : l  Sir  J. 

'Not  only  the  signs  of  some  diseases,  but  their  mindhT 
progress  and  issue,  may  in  measure  be  determined  by  &*****• 
the    patient's   will.      I   mean  ....  by  the    direct 
influence  of  the  will  on  sensation  and  motion.     It 
can  affect  the  character  and  intensity  of  pain,  and 
other  morbid   sensations,  ....  it  can   control  the 
movements  of  muscles  generally  involuntary ;  .  .  .  . 
it  can,  at  least  in  some  degree,  determine  the  methods 
of  some  of  the  processes  of  our  life.' 

Dr.  Goodhart  observes  : 2  '  The  conscious  direction  DM. 
of  attention  upon   any  pain,  however   slight,  for  a  an°a 
length  of  time  will  gradually  make  a  trifle  unbearable  Rennie< 
and  even  agonising.' 

Dr.  G.  E.  Eennie  in  the  '  British  Medical  Journal ' 
recently  says : 3  '  First,  I  would  remind  you  of  the 
immense  influence  exerted  by  the  mind  on  the  body. 
I  need  only  refer,  for  example,  to  the  effect  of  sudden 
emotion,  fear,  or  pleasure  upon  the  heart,  producing 
in  some  cases  merely  palpitation,  at  other  times  actual 
syncope  or  even  sudden  death.' 

Professor  Clouston,  in  his  inaugural  address  to  the 

1  Sir  James  Paget  on  '  The  Use  of  the  Will  for  Health.' 

*  Dr.  Goodhart,  Lancet,  July  1889. 

1  Dr.  G.  E.  Kennie,  British  Medical  Journal,  May  4, 1901. 


72  THE  FOECE  OF  MIND 

cionatraft  R°yal  Medical  Society  in  1896,  which  will  well  repay 
inaugural  the  most  careful  perusal,  says  (the  italics  are  mine) : l 
'  I  would  desire  this  evening  to  lay  down  and  to  en- 
force a  principle  that  is,  I  think,  not  sufficiently,  and 
often  not  at  all,  considered  in  practical  medicine  and 
surgery.  It  is  founded  on  a  physiological  basis,  and 
it  is  of  the  highest  practical  importance.  The 
principle  is  that  the  brain  cortex,  and  especially  the 
mental  cortex,  has  such  a  position  in  the  economy 
that  it  has  to  be  reckoned  with  more  or  less  as  a 
factor  for  good  or  evil  in  all  diseases  of  every  organ,  in 
all  operations,  and  in  all  injuries.  Physiologically  the 
cortex  is  the  great  regulator  of  all  functions,  the  ever- 
active  controller  of  every  organ,  and  the  ultimate 
court  of  appeal  hi  every  organic  disturbance.  We  all 
know  that  every  organ  and  every  function  are  re- 
presented in  the  cortex,  and  are  so  represented  that 
they  all  may  be  brought  into  the  right  relationship 
and  harmony  with  each  other,  and  so  they  all  may  be 
converted  into  a  vital  unity  through  it.  Life  and 
mind  are  the  two  factors  of  that  organic  unity  that 
constitute  a  real  animal  organism.  The  mental 
cortex  of  man  is  the  apex  of  the  evolutionary  pyramid, 
whose  base  is  composed  of  the  swarming  myriads  of 
bacilli  and  other  monocellular  germs  which  we  now 
see  to  be  almost  all-pervading  in  nature.  It  seems 
as  if  it  had  been  the  teleological  aim  of  all  evolution 
from  the  beginning.  In  it  every  other  organ  and 
function  find  their  organic  end.  In  histological 
structure — so  far  as  we  yet  know  this — it  far  exceeds 
all  other  organs  in  complexity.  When  we  fully  know 
the  structure  of  each  neuron,  with  its  hundreds  of 

1  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 


ON  PSYCHO-PATHOLOGY  73 

fibres  and  its  thousands  of  dendrites,  and  the  relation 
of  one  neuron  to  another,  when  we  can  demonstrate 
the  cortical  apparatus  for  universal  intercommunica- 
tion of  nervous  energy,  with  its  absolute  solidarity, 
its  partial  localisation,  and  its  wondrous  arrangements 
for  mind,  motion,  sensibility,  nutrition,  repair,  and 
drainage — when  we  fully  know  all  this,  there  will  be 
?io  further  question  of  the  dominance  of  the  brain 
cortex  in  the  organic  hierarchy,  nor  of  its  supreme 
importance  in  disease.' 

And  further : 1 

'  The  evidence  that   the  brain  cortex   regulates  Organic 
absorption,  secretion,  vascular  tone,  and  the  anabolic  and  the 
and  katabolic  processes  in  the  cells  of  the  tissues  may  m 
now  be  regarded  as  complete.     Sores  in  many  melan- 
cholic persons  will  not  heal.     The  gland  and  the  lung 
tissues  in  idiots  and  dements  are  unable  to  resist  the 
attacks  of  the  tubercle  bacilli,  so  that  two-thirds  of  our 
idiots  and  one-third  of  our  worst  dements  die  of  tuber- 
culous affections.     Brown-  Sequard  showed   that  the 
section  of  certain  cutaneous  nerves,  thereby  cutting 
off  the  cortical  influences  on  the  hair  bulbs,  will  cause 
the  hair  to  become  white  on  these  spots. 

'  When  we  have  localised  cortical  destruction  on  one 
side  of  the  brain  we  have,  as  we  all  know,  resulting 
on  the  opposite  side  of  the  body  not  only  motor 
paralysis,  but  also  wasted  muscles,  liability  to  bed- 
sores, altered  texture  of  the  skin,  and  a  lowered  or 
heightened  temperature.' 

Again  :  '  To  explain  all  these  mental  and  nervous  Mind  ;• 
effects  on  nutrition,  on  function,  and  on  disease,  we 
must  not  forget  that  it  is  gradually  being  demonstrated,  JJJJ 

'  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896.  nutrition. 


THE  FOECE  OF  MIND 


Every -day 
effects  of 
mind  on 
body. 


Effects  of 
day  and 
night. 


All 

diseases 
worse  at 
Bight. 


even  in  our  present  state  of  histological  knowledge, 
that  we  have  a  sufficient  apparatus  in  the  brain  cortex 
and  its  peripheral  connections.  It  is  not  a  vague 
question  of  "  mind  acting  on  body,"  of  imagination 
producing  physical  effects.  The  highest  mental  centres 
can  be  demonstrated  to  have  abundant  and  direct 
connections  with  lower  motor  and  trophic  centres. 
All  the  centres  can  now  be  proved  to  have  strands  of 
fibres  passing  from  the  one  to  the  other,  and  every 
centre  can  be  proved  to  act  on  its  organ,  and  to  be 
reacted  on  in  turn.  Most  people  recognise  that  there 
are  rare  and  striking  effects  of  mind  on  body — few 
fully  realise  its  every-day  effects.  It  is  of  far  more 
consequence  that  our  profession  should  remember  the 
common  than  the  uncommon  in  treating  disease.  If 
one  desired  to  adduce  one  of  the  strongest  illustrations 
of  the  influence  of  the  cerebral  cortex  and  mind  on 
diseases,  one  would  take  the  differences  between  day 
and  night  in  nearly  all  disorders.  We  know  that  at 
night,  and  especially  during  sleep,  the  brain  cortex  is 
in  a  totally  different  state  from  its  condition  during 
the  day,  and  the  mind  is  then  practically  in  abeyance. 
What  is  the  result  on  function  and  disease  ?  Do  not 
all  febrile  affections  become  aggravated  at  night  ? 
Are  not  all  mental  affections  then  at  their  worst? 
Do  not  all  pulmonary  diseases  then  cause  most  pain 
and  distress  ?  Do  not  all  the  worst  exacerbations  of 
the  neuroses  of  sensibility  then  occur  ?  Do  not  the 
worst  and  most  intractable  of  the  convulsive  disorders 
then  come  on  ?  We  can  control  the  day  fits  of  many 
epileptics  wonderfully  by  the  use  of  bromides.  We 
can  seldom  do  any  good  to  the  night  fits  thereby. 
Is  not  asthma  always  worse  at  night  ?  And  is  no 


ON  PSYCHO-PATHOLOGY  75 

night  the  time  when  the  vital  forces  sink  so  low  that 
mankind  mostly  die  in  the  early  hours  of  the  morning? 
The  night-work  of  the  doctor  is  largely  due  to  many  Peculiar 
diseases  being  at  their  worst  then  ;  but  in  addition  to  Sate  at 
this  there  is  a  mental  state  peculiar  to  the  night  both  nighti 
in  the  patient  and  in  his  relatives  from  the  same 
cortical  cause.     Fears,  depressed  views  of  the  result 
of  the  trouble,  anticipations  of  evil,  want  of  courageous 
common-sense  are  then  most  manifest,  and  the  doctor 
is  hurriedly  sent  for,  not,  it  may  be,  because  the 
patient  is  much  worse,  but  because  he  and  his  friends 
think  so.     This  is  a  bit  of  practical  psychology  that  Judgment 
touches  us  all  in  a  very  tender  place,  for  who  likes  to  cieaTat 
turn  out  of  a  warm  bed  and  be  awakened  out  of  a  nightl 
sound  sleep  to  go  out  on  a  cold  rainy  night  ?    What 
man's  courage  is  as  great  at  three  in  the  morning  as 
at  midday  ?     Nay,  what  man's  judgment  is  as  clear 
then  ? ' 

I  think  that  those  who  carefully  read  Dr.  Clouston's 
words  will  feel  that  the  length  of  this  extract  is  amply 
justified  by  the  importance  of  the  matter. 

John  Hunter,  as  is  well  known,  was  fully  alive  to 
the  importance  of  our  subject.  I  will  only  quote  one 
of  his  many  sayings :  '  As  the  state  of  the  mind  is 
capable  of  producing  a  disease,  another  state  of  mind 
may  effect  a  cure.' 

The  bearing  of  temperament  on  disease,  which  is  IJ^0 

;*  influence 

now  again   being   seriously  regarded,  is,   after  all,  of  the 
largely  due  to  the  mental  factor  connected  with  it.  JJJJdy" 
In  all  these  cases,  however,  as  well  as  in  those  special  jJjJJJJ^JJ" 
forms  of  disease  we  are  about  to  speak  of,  one  must 
remember   that  the    mind  is   always  used    uncon- 
sciously. 


76 


THE  FOBCE  OP  MIND 


Physical 

and 

psychic 

ever 

interact. 


Action  of 
the  body 
on  the 
mind. 


Value  of 
the  face  in 
disease. 


The  mind 
muscles  of 
the  face. 


Dr.  Lay- 
cock  on 
physio- 
gnomy of 


The  mental  factor  is,  as  I  have  already  said, 
ubiquitous ;  physical  diseases  and  psychic  conditions 
are  inseparable  both  as  cause  and  effect,  both  in  action 
and  reaction.  Our  subject  here  is  not  the  action  of 
the  body  on  the  mind,  and  I  have  left  this  side  of  the 
subject  so  far  alone  ;  but  one  may  now  be  permitted 
to  point  out  that  in  every  mental  disease  there  is 
probably  some  antecedent  change  of  the  brain,  and 
indeed  that  every  physical  disease  writes  its  story  in 
some  way  on  the  mind. 

On  the  face,  for  instance,  the  diseases  of  the 
body  are  not  only  often  physically  but  mentally 
inscribed.  Dr.  Clouston  says  : l  '  Laycock  was  a  great 
physiognomical  diagnostician,  and  constantly  preached 
its  value  to  his  students.  I  well  remember  a  talk  he 
gave  me  on  the  subject  one  quiet  Sunday  when  he 
and  I  were  alone  in  his  side  room,  in  which  he  assured 
me  that  in  time  I  should  be  able  to  diagnose  half  my 
cases  at  sight  without  further  examination  if  I  gave 
proper  attention  to  what  he  told  me.2  I  have  seen 
him  arrive  at  marvellous  diagnoses  thereby.  The 
muscles  of  the  face  are  emphatically  the  mind  muscles, 
and  they  often  express  in  readable  form,  to  those  who 
observe  them  acutely,  many  most  important  and 
striking  mental  relationships  of  diseases.  The  cortex 
is  the  key  common  to  the  normal  expression  of  dis- 


Laycock  says:  'Study  well  the  physiognomy  of 
disease — that  is  to  say,  all  those  external  character- 
istics in  the  patient  that  reach  the  unaided  senses  and 

1  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 
*  To  carry  this  out  to  the  exclusion  of  other  methods  of  diagnosis 
would  in  my  opinion  be  most  dangerous  in  practice. 


ON  PSYCHO-PATHOLOGY  77 

which  are  associated  ' — associated,  I  would  point  out, 
chiefly  through  the  brain  cortex—'  with  morbid  states, 
whether  they  be  sounds  or  odours  or  visible  and  tangi- 
ble modifications  of  form,  complexion,  expression,  and 
modes  of  functional  activity,  taking  cognisance  of 
minute  modifications  as  well  as  of  the  more  obvious,  for 
they  are  only  minute  in  a  popular  sense.'  If  this  is 
done,  it  is  truly  as  *  scientific '  a  mode  of  diagnosis 
as  any  stethoscopic  or  chemical  investigation.  No 
doubt  some  persons  are  more  tell-tale  physiognomically  BC°P«- 
than  others ;  that  is,  there  is  in  them  a  closer  and  more 
constant  relationship  between  the  organic  and  sensory 
centres  in  the  cortex,  and  the  mental  and  motor  centres 
that  control  the  face  and  attitudes  ;  their  mental 
reflexes  are,  in  fact,  more  acute.  *  Take  as  an  example  a  An 
case.  A  patient  comes  to  you,  and  before  you  ask  him 
a  question,  you  notice  a  glazy  complexion,  especially  j;£°b8erv*~ 
under  the  eyes,  the  eyes  themselves  showing  a  combina- 
tion of  brilliancy  over  the  cornea,  with  pallor  over  the 
conjunctivas,  the  skin  of  the  face  being  rather  muddy, 
the  lips  and  ears  a  bit  dusky,  the  breathing  rather 
heavy,  and  the  activity  of  the  muscular  movements 
diminished.  These  are  signs  of  organic  distress  in 
the  general  mental  expression  of  the  countenance. 
If  still  further  the  patient  has  the  typical  outward 
signs  of  the  arthritic  diathesis — namely,  tall  figure, 
broad  thorax,  full  abdomen,  large  muscles  and  frame, 
limbs  large,  movements  rather  sedate — then,  founded 
on  all  those  outward  phenomena,  which  by  ex- 
perience can  be  taken  in  at  a  glance,  you  form  a 
valuable  primd-facie  case  of  renal-cardiac  disease. 
Beyond  any  doubt,  there  may  be  a  "  gastric  "  or  a  Gastric 
"  renal  "  look,  and  there  may  be  a  "  cardiac  "  or  "  pul-  « Took.1 


78  THE  FOECE  OF  MIND 

monary  "  look  in  a  man's  face.  It  will  be  seen  that 
almost  all  these  outward  signs  arise  through  the 
brain  cortex  being  acted  on  by  the  diseased  organs, 
this  action  being  reflected  in  the  face.' 

Morals  and  In  considering  these  close  sympathies  of  mind  and 
b£dy.and  body  we  are  reminded  here  of  an  interesting  point 
lately  raised  as  to  whether  the  mind  can  remain 
undented  after  voluntary  physical  immoralities. 
It  seems  to  me  that  the  fact  of  evil  thoughts 
being  written  physically  upon  the  face  shows  that 
evil  deeds  are  written  psychically  upon  the  mind; 
and  indeed  every  consideration  of  the  close  niter- 
dependence  of  soul  and  body  must  tend  to  drive 
from  the  minds  of  serious  thinkers  this  mischievous 
philosophical  antinomianism,  which  has  lately  re- 
appeared in  Europe,  into  which  even  a  Maeterlinck, 
so  great  in  many  departments  of  thought,  has  per- 
mitted himself  to  be  beguiled;  and  which  teaches 
that  the  soul  of  a  prostitute  or  of  a  murderer  may 
preserve  its  purity  in  the  midst  of  atrocious  bodily 
acts.  The  soul  may,  indeed,  remain  pure  while  most 
hideous  violences  are  offered  to  the  body  ;  but  to 
absolve  it  from  participation  hi  voluntary  action  is 
surely  a  misconception  of  everything.  Such  a  mis- 
A  grow  conception,  indeed,  that  we  should  not  have  turned 
eeptkn.  aside  from  our  subject  even  to  allude  to  it,  if  it  were 
not  widely  current,  carrying  evil  in  its  train. 

Conciu-  In  concluding  our  present  subject  I  would  say  that, 

having  given  sufficient  illustrations,  largely  from  the 
testimony  of  able  observers  of  the  general  relation  of 
mind  to  disease,  I  will  reserve  further  details  for  the 
next  chapter. 


ON  PSYCHO-PATHOLOGY  79 

I  do  not  think  I  need  apologise  for  the  length  of 
my  quotations  in  this  and  other  chapters,  and  even 
for  reiterating,  as  I  have  done,  some  important  points. 
In  accumulating  evidence  on  any  subject  in  which  the 
writer  is  specially  interested,  his  own  ipse  dixit  should 
not  be  too  prominent ;  and  where  the  testimony  of 
competent  physicians  is  available,  I  think  it  is  best 
to  give  it ;  although  the  style  of  the  book  necessarily 
somewhat  suffers  by  being  disconnected.  At  any  rate, 
it  is  by  these  means  that  I  trust  I  have  established 
that  '  the  mental  factor  is  present  in  some  way  or 
other  in  all  diseases.' 


80  THE  FORCE  OF  MIND 


CHAPTER  V 

TEE  MENTAL  FACTOR  IN  ORGANIC  AND 
OTHER  DISEASES 

4  We  have  examples  of  the  mind  as  a  causal  factor  in 
most  organic  diseases.' 

New          '  I  AM  sure,'  says  Sir  B.  W.  Richardson,1  '  that  modi- 

^mentai     ^e^'  ^  not  new  *orm8  °*  disease,  developed  through 

origin.         the  mind  are  much  more  common  than  they  were ' — 

a  startling  statement,  but  one  supported  widely  by 

medical  experience.     We  need  not,  however,  confine 

our  attention  to  such  new  or  modified  diseases  to  find 

abundant  evidence  of  mind  action. 

Without  committing  himself  definitely  as  to  which 
is  cause  and  which  effect,  Sir  B.  W.  Richardson  connects 
certain  mental  diseases  (to  which,  if  I  mistake  not, 
he  stands  sponsor)  with  certain  physical  conditions : 
•  Delirium  Inquietans,'  for  instance,  he  connects  with 
valvular  disease  of  the  heart ;  '  Delirium  Dubitans,' 
with  '  changeable '  diseases  and  intermittent  fevers ; 
'  Delirium  Sperans,'  with  tubercle  ;  '  Delirium  De- 
sperans,'  with  disease  of  the  rectum. 

Dr.  Lya1  Dr.  Grabham  Lys  says  that  mind  produces  athe- 

roma,  dilated  heart,  Graves'  disease,  dyspepsia,  jaun- 
dice, cirrhosis,  chorea,  cancer,  pernicious  anaemia, 
foetal  deformities,  and  alopecia. 

1  Sir  B.  W.  Rich&rdson,  Discourse,  p.  16. 


THE  MENTAL  FACTOE  IN  DISEASES      81 

I  suppose  he  means  that  in  each  of  these  diseases 
there  are  numerous  instances  where  the  most  obvious 
cause  at  any  rate  has  been  the  mental  factor. 

Dividing  the  mind   into  emotion   and  intellect,  Die 
I  find  that  Emotion  has  caused  unconsciously  nume-  by 
rous  cases  of  epilepsy,  diabetes,  jaundice,  urticaria,  emotloni 
rachialgia,  paralyses,  boils,  cancer,  gastric  diseases, 
retention,   amenorrhoea,  granular  kidney,   and  ana- 
sarca. 

The  Intellect,  on  the  other  hand,  has  a  much  less  Diseases 
intimate  connection  with  organic  diseases  ;  and  from 
what  I  have  adduced  as  to  the  relative  power  of  the 
conscious  and  unconscious  faculties  on  the  body,  the 
reason  is  clear.  Emotion  in  its  varieties  is  often 
wholly  or  partly  unconscious,  whereas  the  intellect  is 
almost  always  exercised  consciously,  though  its  effects 
upon  the  body  are  wrought  by  the  unconscious  mind, 
apart  from  the  direct  action  of  the  will.  The  results 
are  therefore  much  shallower  and  more  superficial, 
and  nearly  always  functional. 

Although  my  subject  in  this  chapter  is  more 
especially  organic  disease,  I  will  enumerate  some  of 
the  effects  of  the  intellect  on  the  body. 

The  intellect  can  influence  and  produce  indirectly  J 
through  the  unconscious  mind  hyperaesthesia,  anaes- 
thesia, paraesthesia,  dysaesthesia,  and  all  varieties  of 
special  sensation.  Intellect  can  contract  or  relax 
muscles,  and  cause  all  movements,  including  irregular 
and  excessive  movements,  spasms,  and  convulsions. 
It  can  also  produce  loss  of  muscular  power  and  para- 
lysis. Intellect  can  in  the  same  way  influence  the 
involuntary  muscles  of  the  heart,  lungs,  blood-vessels, 
bowels,  also  those  in  all  organs.  It  also  can  affect 

o  2 


82  THE  FOKCE  OF  MIND 

the  salivary  and  mammary  glands,  digestion,  excretion, 
secretion,  and  general  nutrition. 

Diseases  The  sympathetic  system,  which  is  largely  governed 

plCo      by  the  mental  emotions,  causes  functional  diseases  of 

origin.         a]j  parts  and  many  organic  diseases — inflammations, 

oedema,  goitre,  exophthalmic  goitre,  headache,  angina 

pectoris,  diabetes,  Addison's  disease,  and  neuroses  of 

the  extremities. 

It  is  interesting  to  note,  hi  comparing  the  volun- 
tary and  involuntary  systems,  that  it  is  decidedly  the 
former  (which  to  some  extent  is  under  the  control  of 
the  conscious  mind)  that  is  most  easily  paralysed  and 
suffers  most  from  disease. 

I  must  not  traverse  in  detail  the  ground  so  ably 
covered  by  Hack  Tuke  in  recording  at  length  the 
numerous  instances  known  of  physical  diseases  of 
mental  origin ;  but  will  be  content  very  briefly  to 
summarise  the  evidence  at  my  disposal  under  this 
head. 

Diseases  of         Let  us  commence  with  the  heart  and  circulation. 
duSibT    Dr-  Sansom,  in  the  ' Twentieth  Century  Practice  of 
ada&»         Medicine,'  says  :  '  Mental  overstrain  is  a  more  frequent 
cause  of  a  morbid  condition  of  arteries,  heart,  and 
kidneys  than  is  generally  admitted.     The  influence  of 
protracted  emotion  in  the  production  of  arterial  and 
cardiac  disease  is  real.     It  has  been  proved  by  Mosso 
that  emotions  produce  a   spasmodic   contraction  of 
the  arterioles.'    '  Strong  and  repeated  emotions,'  says 
Huchard, '  can  induce  cardiac  affections  by  their  strong 
action  on  the  peripheral  circulation.     Hence  arterio- 
sclerosis is  so  common  amongst  doctors,  politicians, 
"irdnil.       an^  financiers''     The  emotion  of  anger  has  been  spe- 
tion.  cially  investigated  with  reference  to  arterial  pressure. 


THE  MENTAL  FACTOE  IN  DISEASES      83 

It  is  found  capable  of  increasing  the  pressure  of  blood 
from  14  to  21  cub.m.  in  men,  and  the  blood  corpuscles 
from  8  to  4^  millions  per  m.m.  The  connection  of  fear 
with  the  circulation  is  well  known.  Not  only  is  the 
skin  blanched,  but  the  pulse  often  becomes  irregular. 
'  Am  I  afraid  ? '  said  Louis  XVI.  once  in  a  crisis  in  the 
Revolution  ;  '  feel  my  pulse.' 

John  Hunter  says  :  '  An  exciting  cause  of  angina 
pectoris  has  long  been  known  to  be  emotional  excite- 
ment.' 

Dr.  Lys  speaks1  of  both  apoplexy  and  anaemic  bruits 
occurring  during  mental  anxiety,  being  caused  by 
arterial  tension,  also  of  many  cases  of  atheroma  where 
no  cause  is  known  but  some  mental  disorder.  Also  of 
cardiac  dilatation  in  young  people  which  may  be  due 
to  palpitation  from  the  increased  vascular  tension  of 
mental  origin. 

Respecting  atheroma,  Clifford  Allbutt  says  he  knew  Atheroma, 
'  a  young  man  whose  pulse  tracing  for  twelve  months  Und""*1 
during  severe  anxiety  showed  increased  tension.'  anasarca. 

Dr.  Stephen  Mackenzie  gives  three  striking  cases 
of  pernicious  anaemia  caused  by  mental  shock. 

Dr.  Bateman  tells  us 2  of  a  poor  woman  who  got 
general  anasarca  in  the  night  after  the  loss  of  all  her 
money  (only  a  small  sum). 

Turning  to  the  lungs  and  breathing,  asthma  and  i^ng 

,    ,  .  ,        diseasea 

various   forms  of  dyspnoea,   coughs,   and  hiccoughs  of  mental 
are  largely  influenced  by  mind.     Sir  Henry  Holland  ongin' 
says :  '  I  have  known  asthmatic   patients  in   whom 
attacks  are   brought  on  by   seeing  them  in  others.' 

1  Dr.  Lys,  Lancet,  1892,  i.  904. 

»  Dr.  Bateman,    Practical  Symptoms  of   Cutaneous    Disease, 
7th  edit.  p.  214. 


84  THE  FOKCE  OP  MIND 

Haemorrhage  from  the  lungs  has  been  frequently 
traced  to  mental  causes.  Sir  James  Paget  tells  us  of 
a  young  man  who  had  haemoptysis  on  his  birthday, 
and  for  nine  years  after  on  his  birthday,  being  quite 
free  between.  He  died  of  rapid  consumption  after 
the  tenth  anniversary. 

Dr.  Sweetzer  tells  us  of  a  lady,  who,  feeling  a 
living  frog  fall  into  her  bosom  from  the  clutches  of  a 
bird,  was  seized  with  such  profuse  haemoptysis  that 
she  lived  only  a  few  minutes. 

Digests  The  digestive  organs,  including  the  liver,  are,  as  is 

of8mentai     we^  known?  greatly  affected  by  the  mind,  and  woe 

origin.        betide  the  practitioner  who  fails  to  remember  this  in 

some  obscure  case  of  dyspepsia  or  mal-assimilation. 

Anorexia,  nausea,   dyspepsia,   flatulence,   gastralgia, 

constipation,  and  diarrhoea  are  all  often  either  caused 

or  largely  affected  by  the  mental  factor. 

Jaundice  from  mental  emotion  is  recorded  by 
Sir  S.  Wilks  ; l  jaundice  from  anxiety  specially  by  Dr. 
Churton.2  Jaundice  has  also  been  caused  by  fits  of 
anger  and  fear.  A  medical  student  had  an  attack 
brought  on  by  a  severe  examination.3 

Dyspepsia  '  Barristers,'  Dr.  Fletcher  tells  us,  '  commonly 
oriSnntal  BUffer  fr°m  dyspepsia  during  the  assizes,  which  dis- 
appears at  once  when  the  anxiety  is  over.'  Dyspepsia, 
indeed,  of  all  diseases,  is  the  most  easily  produced  by 
the  mind.  Dr.  Clouston  observes  with  regard  to 
dyspepsia  : 4  '  The  mental  attitude  of  the  physician  is 
often  changed  somehow,  when  he  is  treating  his 

1  Sir  8.  Wilks,  British  Medical  Journal,  July  2, 1870,  p.  4. 

•  Dr.  Churton,  British  Medical  Journal,  November  19, 1870,  p.  547. 

»  Dr.  Hack  Tnke,  Mind  and  Body. 

4  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 


THE  MENTAL  FACTOE  IN  DISEASES      85 

patient's  indigestion  and  constipation,  as  compared  with 
that  with  which  he  considers  and  treats  the  mental 
pain  that  accompanied  and  perhaps  caused  the  indi- 
gestion. The  indigestion  took  its  real  origin,  it  may 
be,  in  a  disturbance  of  the  action  of  the  mind  and 
brain  cortex,  but  the  stomach  only  is  thought  of  or 
treated  by  peptones,  acids,  or  laxatives,  and  this  is 
called  "  scientific  "  treatment.  We  do  not  need  to 
hypnotise  a  patient  to  show  that  the  mental  centres 
in  the  cortex  have  the  power  of  directly  influencing 
physiological  function  and  tissue  nutrition.  In  mental 
disease,  which  means  cortical  disease,  every  one  of 
these  functions  is  commonly  enough  affected.  The 
dry  skin,  the  foul  tongue,  the  constipation  and  mal- 
assimilation,  of  certain  melancholies,  the  greasy, 
odorous  perspiration,  the  phosphatic  urine,  and  the 
constant  flow  of  speech,  of  many  maniacal  cases,  are 
every-day  examples.' 

Vomiting  is  not  only  excited  by  injuries  to  the 
brain,  apart  from  disorders  of  the  stomach,  but  by  the 
mind  alone.  A  house  surgeon  of  Dr.  Durand  gave 
one  hundred  patients  coloured  water,  and  told  them  it 
was  a  strong  emetic  given  in  mistake.  Eighty  of 
them  were  violently  sick  in  consequence.  With 
regard  to  the  liver,  we  have  given  one  or  two  instances  liver, 
of  mental  action  ;  but  there  can  be  no  doubt  that  in 
this  case,  as  in  all  digestive  disease,  the  effect  of  the 
malady  upon  the  mind  is  more  powerful  than  the 
power  of  the  mind  in  causing  the  disease. 

In  connection  with  the  action  of  the  mind  on  the  a 

digestive  canal,  I  will  give  a  striking  instance  of  its  duetoth* 
power  in  producing  a  disease,  so  incredible  on  the  face 
of  it,  that  it  is  well  to  say  that  I  will  personally  vouch 


86  THE  FOECE  OP  MIND 

for  every  detail.  Early  in  1897  a  woman  was  ad- 
mitted into  a  London  hospital  with  faecal  vomiting. 
Her  abdomen  was  covered  with  the  scars  of  various 
laparotomies  made  in  order  to  find  out  the  cause. 
The  whole  of  the  abdominal  contents  had  already 
been  carefully  examined,  but,  as  the  vomiting  persisted, 
a  fresh  opening  was  made  once  more  and  the  colon 
specially  overhauled.  All  the  viscera  were  healthy  ; 
nevertheless  the  faecal  vomiting  was  genuine.  Most 
careful  experiments  conducted  by  the  surgeon  and 
house-surgeon  yielded  almost  incredible  results.  Two 
K^ark-  ounces  of  castor  oil  introduced  into  the  rectum  were 
periments.  vomited  with  faecal  matter  in  from'  ten  to  fifteen 
minutes.  Half  a  pint  of  water  stained  with  methyl 
blue  introduced  into  the  rectum  was  vomited  in  the 
same  time,  and  so  on.  The  cause  of  this  marvellous 
reversed  peristalsis  was  purely  mental,  and  the  patient 
was  eventually  relieved  by  wholly  mental  discipline 
and  therapeutics,  and  was  discharged  cured.  Although 
this  confessedly  is  a  case  of  functional  disease,  it 
nevertheless  remains  one  of  the  most  remarkable 
instances  of  the  power  of  the  unconscious  mind  over 
the  body.  To  some,  perhaps,  this  seems  too  much  to 
assume.  But  let  us  see  if  any  alternative  theory  is 
possible.  The  abdomen  had  been  repeatedly  opened 
in  the  belief  that  the  cause  was  physical  and  material, 
but  without  result.  Moreover,  the  cure  was  effected 
The  without  the  removal  of  any  physical  irritant  or  other 

Averted  aSent-  The  cause  was  therefore  mental,  or,  if  this 
action  of  still  be  objected  to,  let  us  at  least  take  refuge  in 
conscfous  '  Nature '  or  '  Physiology.'  In  the  second  place,  we  have 
1nmd-  no  conscious  mental  power  that  could  produce  such  a 
disgusting  action,  even  if  we  wished.  If  any  doubt  this, 


THE  MENTAL  FACTOB  IN  DISEASES      87 

let  them  try,  and  they  will  find  the  reign  of  the 
conscious  mind  has  its  fixed  limits  all  over  the  body, 
as  we  have  shown,  which  are  in  sharp  contrast  to  the 
more  extensive  and  apparently  universal  powers 
possessed  by  the  '  unconscious  mind.'  In  this  case,  Conscious 
for  instance,  the  powers  of  the  conscious  will  cease  at  ceases 
the  fauces  or  pharynx  ;  all  beyond  knows  not  its  sway. 
Nevertheless,  it  is  far  from  being  in  a  state  of  anarchy : 
the  presence  of  a  controlling  power,  ordering  all  to 
one  end,  is  perhaps  even  more  evident  beyond  the 
fauces  than  on  this  side.  The  power  that  reversed 
peristaltic  action  without  any  mechanical  or  material 
cause  is  not  therefore  only  mental,  but  shown  to  be 
unconscious  by  two  facts.  The  woman  had  no  idea 
it  was  effected  by  her  mind  at  all,  and,  if  she  had,  all 
her  conscious  power  could  not  have  produced  it. 
What  caused  it,  therefore,  was  neither  '  conscious '  nor 
*  sub -conscious,'  but  '  unconscious  '  mind  ;  and  the 
disease  necessarily  remained  incurable  until  this 
unconscious  mind  was  reached,  and  made  to  undo  the 
evil  work  it  had  done. 

The  kidneys  and  bladder  are  affected  organically  Kidney 
by  the  unconscious  mind.     Diabetes  is  undoubtedly  of  mental 
caused   by   mental   strain.     Sir    B.   W.   Eichardson  origin- 
records  such  cases,  and  says  :  '  Diabetes  from  sudden 
mental  shock  is  a  true  pure  type  of  a  physical  malady 
of  mental  origin.' l 

Van  Noorden,  in  '  Twentieth  Century  Practice  of 
Medicine,'  says  :  '  There  are  many  carefully  observed 
cases  of  diabetes  on  record,  in  which  the  disease 
followed  a  sudden  fright  or  joy,  or  some  other  dis- 
turbance of  the  mental  equilibrium.' 

1  Brunton,  Pavy,  and  others  also  give  mind  as  a  cause. 


88  THE  FOKCE  OP  MIND 

Urine  and          Apart  from  disease,  the  mind  naturally  affects  the 

the  mind.     rena}  secretion.     Eleven  parts  of  urine  are  secreted  in 

repose,   compared  with  thirteen  when  the  brain  is 

active  (allowing  for  other  disturbing  factors).     The 

amount  of  urea  is  also  augmented. 

Dr.  Clifford  Allbutt  says  it  is  an  undoubted 
clinical  fact  that  granular  kidney  is  often  produced 
by  prolonged  mental  anxiety. 

Incontinence  and  retention  are  both  produced  by 
the  mind  apart  from  physical  causes,  and  are  also 
often  aggravated  by  it  where  these  are  present. 

It  is  an  interesting  fact,  though  it  proves  nothing, 
that  from  sympathy,  after  the  death  of  Napoleon  III., 
four  persons  consulted  Sir  James  Paget  for  stone 
in  the  bladder  who  had  no  physical  sign  of  it,  though 
they  described  the  symptoms. 

Cancer  and         Cancer  has  often  a   discernible  mental  factor,  if 
the  mind.    not  an  efficien{;  mental  cause.    Sir  George  Paget  says : l 
1  In  many  cases  I  have  reason  for  believing  that 
cancer  had  its  origin  in  prolonged  anxiety.' 

Dr.  Murchison  says  :  '  I  have  been  surprised  how 
often  patients  with  primary  cancer  of  the  liver  have 
traced  the  cause  of  this  ill-health  to  protracted  grief 
or  anxiety.  The  cases  have  been  far  too  numerous  to 
be  accounted  for  as  mere  coincidences.' 

Dr.  Snow  ('  Lancet,'  1880)  even  asserts  his  con- 
viction that  'the  vast  majority  of  cases  of  cancer, 
especially  of  breast  and  uterine  cancer,  are  due  to 
mental  anxiety.' 

Sir  W.  H.  Bennett,  speaking  at  St.  George's 
Hospital  (January  1899),  tells  us  of  cases  of  increased 
growth  of  tumours  following  constant  attention. 

1  Sir  George  Paget,  Lectures. 


THE  MENTAL  FACTOR  IN  DISEASES      89 

We  find  thoughts  unconsciously  acting  freely  on 
the  skin  secretions,  in  arresting  or  increasing  them. 
Sir  B.  W.  Eichardson  says : l  '  Eruptions  on  the 
skin  will  follow  excessive  mental  strain.  In  all  these, 
and  in  cancer,  epilepsy,  and  mania  from  mental 
causes,  there  is  a  predisposition.'  'It  is  remark- 
able,' he  adds,  '  how  little  the  question  of  the  origin 
of  physical  diseases  from  mental  influences  has  been 
studied.' 

As  to  infectious  diseases,  the  mind  is  a  potent 
factor.  A  doctor  owes  his  immunity  to  this  fact  far 
more  than  to  any  care  he  takes,  and  so  do  nurses. 
The  surest  way  to  be  attacked  with  an  infectious 
disease  is  to  be  afraid  of  it.  Fear  and  the  thought 
of  sickness  are  of  themselves  sufficient  to  cause  the 
same  (provided  the  germ  be  present). 

With  regard  to  cholera,  Sir  W.  Stokes  says  :  '  The 
first  sight  of  cholera  patients  gives  rise  to  symptoms  of  mind, 
cholera  afterwards.' 

Sir  S.  Baker,  the  explorer  of  the  Nile,  says  that 
'  any  severe  grief  or  anger  is  almost  certain  to  be 
succeeded  by  fever  in  certain  parts  of  Africa.' 

'  In  the  general  paralysis  of  the  insane  (apart  from 
syphilis),'  according  to  Dr.  Mickle,  endorsed  by  Dr. 
Blandford,  '  mental  strain  and  overstrain  are  the 
great  pathological  factors.' 

Scurvy  is  often  stopped  by  naval  engagements, 
and  the  British  Fleet  is  remarkably  healthy  after 
victories ;  while  Professor  Rolleston  points  out  that 
after  defeat  an  army  '  readily  succumbs  to  dysentery, 
scurvy,  malarial  fever,  and  other  diseases,  that  have 
comparatively  little  effect  in  opposite  circumstances. 

1  Sir  B.  W.  Bichardson,  Field  of  Disease,  p.  618. 


90  THE  FOKCE  OF  MIND 

Dr.  Lys  says  :  '  '  In  every  case  of  Graves'  disease 
(exophthalmic  goitre)  there  is  a  morbid  mental  state 
of  a  constant  character  which  precedes  its  development, 
and  consists  of  depression  with  extreme  irritability.' 
Dr-  Dr.   Clouston   says  : 2   'If  one  wanted  a  special 

on°U8  illustration  of  the  mental  and  nervous  relation  of 
influenza.  &n  infectjve  feverj  one  ^ould.  select  influenza.  The 
microbe  or  its  ptomaines  have  a  special  affinity,  there 
can  be  no  doubt,  for  the  higher  nervous  centres. 
They  eat  up  and  destroy  the  nerve  and  mental  energy. 
No  mental  and  no  nervous  effort  is  possible  while  the 
disease  lasts  with  most  people ;  and  the  nerve  cells, 
being  the  highest  and  most  delicate  in  the  organism, 
take  by  far  the  longest  to  recuperate.  The  simplest 
but  most  effectual  mode  of  conserving  and  restoring 
nerve  energy  by  going  to  bed  at  once,  and  staying 
there  a  long  time,  is  never  so  necessary  as  in 
influenza.' 

Muscular   inco -ordination   seems    to    arise   from 
some  error  in  the  action  of  the  unconscious  mind. 

Insomnia  and  tinnitus  aurium  are  largely  vices  of 
the  nerve  centres. 

Pains  Arc.          Keflex  pain  is  often  felt  from  mental  shock,  or 

mantel by    a  sharp  twinge  on  the  receipt  of  bad  news.     Other 

action.        symptoms  are  '  the  back  opening   and   shutting,'  a 

sudden  backache  with  an   acid  taste  in  the  mouth, 

and  the  teeth  on  edge,  also  muscular  tremors  and 

weakness    of   the    legs.     I  was  walking  in  Victoria 

Station  the  other  day  with  a  lady  in  perfect  health, 

but  of  nervous  temperament.     The  receipt  of  some 

bad  news  made  her  reel  about  and  lurch  from  side  to 

1  Dr.  Lys,  The  Lancet,  1892,  i.  905. 

*  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 


THE   MENTAL  FACTOR  IN  DISEASES      91 

Bide  as  if  intoxicated ;  while  her  natural  gait  was 
replaced  by  short  steps  on  her  toes  as  in  paralysis 
agitans,  which,  by  the  way,  is  another  disease  in 
which  the  mental  factor  acts  as  a  causal  agent. 

Turning  to  uterine  diseases,  we  may  couple  the  uterine 
action  of  the  mind  with  the  growth  of  fibroids,  with  andtS" 
abortion  and  premature  labour,  with  conception  and  nund' 
its  products,  both  in  their  mental  and  physical 
characters.  Dr.  Clouston  observes  : l  '  Nothing  is  more 
common  than  for  the  menstrual  discharge  to  be 
diminished,  arrested,  or  increased  by  mental  and 
nervous  influences.  Any  practitioner  of  physic  who 
treats  menstrual  disturbances  without  reference  to 
the  patient's  mental  and  general  brain  condition  will 
certainly  not  succeed  fully  in  his  efforts.  The  whole 
subject  of  the  function  of  reproduction  and  sex  is 
quite  as  much  mental  as  bodily.  It  relates  as  much 
to  the  brain  cortex  and  the  mind  as  to  the  organs  of 
sex  and  generation.  A  man  who  treats  spermatorrhoaa, 
masturbation,  impotence,  hysteria,  and  the  allied 
affections  without  taking  into  account  the  affective 
and  inhibitory  state  of  his  patient,  and  without  using 
moral  and  mental  means  as  well  as  physical  agencies, 
is  certainly  acting  on  unphysiological  lines. 

'  I  cannot  help  adverting  here  to  what  I  consider  J?£   ^ 
the  rash   and  unjustifiable  way  the  operations   of  on  cast™ 
castration  and  removing  the  ovaries  and  appendages  tlon' 
were  recently  looked  at,  without  any  reference  to  their 
mental  effects  on  the  subjects  of  them.    We  know 
that  there  are  two  primary  instincts  in  all  the  higher 
animal    kingdom— to    live    and    to   reproduce.     No 
philosophic-minded  gynaecologist  can  look  lightly  on 

1  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 


92  THE  FOBCE  OF  MIND 

the  deliberate  extinction,  by  surgical  means,  of  the 
essential  organs  of  reproduction.  Profound  mental 
changes  commonly  follow  after  this  in  young  subjects. 
The  difference  between  the  mental  qualities  of  an 
ox  and  a  bull  should  be  sufficiently  evident  even  to 
the  most  surgical-minded  gynaecologist.  Yet  I  have 
seen  the  operation  recommended  with  as  little  con- 
sideration of  mental  consequences  as  the  opening  of 
a  whitlow.  Depend  upon  it,  it  may  be  almost  as 
great  a  crime  to  castrate  as  to  kill.' 

Dr.  Ormerod  gives  a  case  where  a  mother  in 
pregnancy  injured  two  fingers  of  the  right  hand,  the 
child  being  afterwards  born  with  two  fingers  imperfect. 

Dr.  Owen l  gives  another  case  of  a  pregnant 
woman  whose  brother  was  genitally  deficient.  Her 
child,  a  male,  was  born  similarly  defective. 

^k0  acti°n  of  the  mind  on  the  products  of  con- 
pairing,  ception,  though  not,  perhaps,  coming  under  the  head 
of  disease,  may  be  conveniently  considered  here,  and 
affords  remarkable  proof  of  the  power  (presumably) 
of  the  mental  factor. 

Dr.  Lowe,  in  the  '  British  Medical  Journal,'  says  * 
that  the  lasting  effects  of  pairing  in  animals,  both 
in  the  male  and  female,  are  to  his  mind  conclusive 
of  the  way  in  which  the  mind  of  the  parent  can  un- 
consciously impress  physical  characteristics  on  the 
Jj^,  offspring.  He  selects  about  half  a  dozen  experiments, 
experi-  which  speak  for  themselves. 

1.  He  says  that  a  white  sow  with  a  black  Berk- 
shire boar  produced  a  litter  of  black  and  white  pigs. 
This  sow  next,  with  a  red  Tamworth  boar,  although 

1  Dr.  Owen,  Lancet,  1892,  i.  969. 

«  Dr.  Lowe,  British  Medical  Journal,  October  81, 1896. 


THE  MENTAL  FACTOK  IN  DISEASES      93 

there  was  no  black  in  either  of  the  parents,  produced 
a  progeny  which  were  red,  black,  and  white,  the 
patches  of  black  being  very  conspicuous. 

2.  A  black  sow  and  boar  (Puckering  breed)  had 
always  bred  their  progeny  black.  The  boar  then  was 
put  with  a  white  sow  for  the  first  time  ;  two  months 
later  it  was  back  with  the  original  black  sow,  which 
then  produced  a  litter  of  black  and  white  pigs, 
although  there  was  no  white  in  either  of  the  parents. 

8.  A  shorthorn  cow  with  an  Alderney  bull  pro- 
duced a  calf  which  was  half-bred  Alderney.  After- 
wards, this  same  cow,  with  a  shorthorn  bull,  had 
another  calf,  which  was  still  partly  Alderney. 

4.  A  smooth  fox-terrier,  by  a  rough  Scotch -terrier, 
had    rough   pups.      Afterwards,   by   a   smooth   fox- 
terrier,  it  had  pups  which  were,  many  of  them,  rough- 
coated,  and  none  were  like  the  parents. 

5.  A  Manx  tailless  tom-cat  paired  with  an  ordinary 
English  cat,  and  some  of  the  kittens  had  either  no 
tails  or  very  short  ones.     The  tailless  tom-cat  died 
some  years  ago,  but  up  to  the  present  time  a  few 
tailless  kittens  are  still  born. 

6.  A   fair  light-haired    Englishman    married    a 
Brazilian  lady,  but  had  no  children.      Twenty  years 
after  he  married  a  light-haired  English  lady,  who 
subsequently  had  a  dark-haired  son  who  was  more 
Brazilian  in  appearance  than  English. 

Dr.  Lowe  can  give  numbers  of  different  cases  of 
cows,  cats,  pigs,  rabbits,  sheep,  &c.,  but  thinks  these 
examples  will  sufficiently  illustrate  this  phenomenon. 

Case  No.  6  is  alluded  to  as  follows  in  the  next  Dr. 

,       _       . _      ,  Neale'i 

issue  by  Dr.  Neale :  comment* 

'The  solution   to  this   problem   appears   to  me 


94  THE  FOECE  OF  MIND 

"  psychological  imprint ; "  that,  having  been  deeply 
attached  to  his  Brazilian  wife,  and  having  dwelt 
lovingly  upon  her  memory  for  twenty  years,  the 
resulting  offspring  from  his  "  fair  English  wife  "  bore 
the  traces  of  long-continued  mental  impressions 
rather  than  the  result  of  merely  having  lived  many 
years  previously  with  a  lady  of  a  darker  hue.' 

A  thoughtful  study  of  these  cases  will  leave  the 
reader  with  the  profound  conviction  that  the  cause  is 
undoubtedly  psychical  and  not  physical. 

Pre-natal  The  effects  of  pre-natal  impressions   on  the  off- 

•ions?8  8Prmg>  °f  which  there  seems  undeniable  evidence, 
also  afford  a  striking  illustration  of  the  influence  of 
suggestion.  '  The  story  of  Jacob  getting  Laban's 
flock  to  breed  striped  cattle  by  means  of  suggestion 
(Gen.  xxx.)  testifies  to  the  antiquity  of  a  belief  which 
seems  less  incredible  as  our  knowledge  extends.' ' 
Charles  ^  The  mother  of  Charles  Kingsley  believed  that 

casT* e;  8  impressions  made  on  her  own  mind  before  the  birth 
of  the  child  for  whose  coming  she  longed  would  be 
mysteriously  transmitted  to  him ;  and  in  this  faith, 
for  his  sake  as  well  as  her  own,  she  luxuriated  in  the 
romantic  surroundings  of  her  Devonshire  home  and 
in  every  sight  and  sound  which  she  hoped  would  be 
dear  to  her  child  in  after  life.  These  hopes  were 
realised ;  and  though  her  son  left  Devon  when  he 
was  six  weeks  old,  and  never  saw  his  birthplace  till 
he  was  a  man  of  thirty,  it  and  every  Devonshire  scene 
had  a  mysterious  charm  for  him  throughout  life.2 

Lastly,  passing  beyond  disease,  there  are  various 
mental  actions  which  can  produce  death  itself,  though 

1  Professor  Barrett  (Dublin),  Humanitarian. 
•  Charles  Kingsley,  Life,  L  4. 


THE  MENTAL  FACTOE  IN  DISEASES      95 

they  themselves  can  neither  be  measured  nor  demon- 
strated. 

I  will  give  a  few  instances  mainly  from  Dr.  Tuke's  Death 

hnnk  •  from 

mental 

'In  May  1873  a  stockbroker  in  Paris  fell  down  causea> 
in  an  apoplectic  fit,  and  soon  died  on  hearing  that  his 
valet  had  been  found  shot  through  the  head.' 

In  the  '  Lancet,'  1867,  is  the  case  of  a  woman 
forty-three  years  old  who  died  in  a  fit  from  finding 
her  daughter,  whom  she  supposed  to  have  been  killed 
in  a  railway  accident,  come  home  unexpectedly. 

A  woman,  having  nursed  her  sister  during  a  long 
illness  until  her  death,  did  not  then  give  way  to 
grief,  but  appeared  perfectly  unmoved.  A  fortnight 
after  she  was  found  dead  in  her  bed,  but  there  was 
no  post-mortem  cause  found,  except  the  depressing 
influence  of  pent-up  grief  through  the  nervous  system. 

'A  laundress  coming  home  along  a  lonely  road 
from  a  solitary  walk  looked  ill  and  excited ;  she  said 
that  a  man  had  jumped  out  of  a  cemetery  as  she 
passed.  She  died  at  the  supper  table.  The  post- 
mortem examination  showed  all  the  organs  healthy 
except  the  heart,  and  the  verdict  was  "  Death  from 
syncope  due  to  shock."  ' 

Dr.  Walshe  says  :  '  A  man  came  to  insure  his  life 
in  full  vigour  and  was  rejected,  and  told  he  had  a 
diseased  heart.  He  became  melancholic  and  died  the 
week  after.' 

Signer  Laura,  in  reporting  on  a  station  master  who 
had  died  suddenly  after  hearing  that  his  station  had 
been  robbed,  points  out  that  '  sudden  mental  emotion 
may  cause  death  in  persons  of  robust  health  in  a  very 
remarkable  way.' 

H 


96  THE  FORCE  OF  MIND 

Only  recently  I  heard  of  a  case  in  the  South  of 
Scotland  when  two  medical  men  were  walking  together, 
and  one  was  saying  that  he  could  make  a  man  ill 
by  merely  talking  to  him  (I  do  not  give  the  doc- 
tor's name  for  obvious  reasons).  The  other  doctor 
doubted  this.  So,  seeing  a  labourer  in  a  field,  the  first 
speaker  went  up  to  him,  and,  telling  him  he  did  not 
like  his  appearance,  proceeded  to  diagnose  some  grave 
disease.  The  man  was  profoundly  struck,  left  off 
work  soon  after,  feeling  very  ill,  took  to  his  bed,  and 
in  a  week  died;  no  sufficient  physical  cause  being 
found.  This  was  of  course  a  shocking  misuse  of  the 
power,  causing  great  grief  at  the  time  at  the  un- 
expected and  fatal  result. 

Overwork  Overwork  causes  eventually  death  of  mind  and 
andSb™dyd  bodv-  At  Cambridge  recently  the  Third  Wrangler 
alone  survived,  the  Senior  and  Second  having  died. 
A  man  may  be  intended  by  Nature  to  be  third  or 
thirtieth  Wrangler.  If  he  gets  first  it  is  only  at  seriouy 
peril.  There  are  few  greater  causes  of  ill-health  than 
the  mental  factor  '  ambition.' 

Dr  May  I,  in  closing  this  chapter,  give  one  more  extract 

Clouston     from  Dr<  Clouston  ?  He  says  : l '  It  seems,  indeed,  as  if 

onprotec-  J 

tion  of  a  certain  persons  who  are  predisposed  to  special  diseases 
cortel  have,  as  their  great  protective  and  prophylactic  against 
them,  a  sound  and  well-working  mind  and  brain  cortex. 
When  well  in  mind,  they  are  sound  in  body.  When 
disturbed  in  mind,  they  fall  victims  to  their  diathesis. 
I  have  no  doubt  myself  that  this  is  the  strongest  cf 
all  the  forces  from  within  that  preserve  health  and 
protect  from  disease.  It  is  now  generally  recognised 
that  death  takes  place  with  most  men,  not  because 

'  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 


THE  MENTAL  FACTOE  IN  DISEASES      97 

disease  is  overmastering,  but  because  the  resisting 
power  against  it  at  the  time  is  lessened.  A  man  gets 
over  many  attacks  of  bronchitis  till  he  is  past  seventy, 
and  then  his  nervous  resistance  becomes  too  weak 
effectually  to  save  his  life.  The  degenerating  cortex,  as 
old  age  conies  on,  not  only  loses  its  faculties  of  memory 
and  keen  volition,  but  a  trophic  energy  which  it  has 
hitherto  supplied  to  the  organs  and  tissues ;  so  that 
we  have  atheroma,  the  senile  heart,  a  shrivelled  skin, 
and  many  other  tissue  degenerations.  In  fact,  a  bad 
memory  and  an  attack  of  senile  eczema  in  a  man  of 
seventy -five  may  result  from  the  same  central  nervous 
cause.  For  the  healing  as  well  as  for  the  prevention 
of  disease,  a  sound  cortex  and  a  cheerful  and  a  buoyant 
mind  are  all-important.' 

Nothing  more  need  be  added  to  prove  the  argument 
of  this  chapter,  that  '  we  have  examples  of  the  mind 
as  a  causal  factor  in  most  organic  diseases.' 


THE  FOBCE  OF  MIND 


CHAPTEE  VI 

THE  CAUSE  AND  SYMPTOMS  OF  FUNCTIONAL 
NERVE  DISEASE 

•The  mental  factor    in   neurasthenia    is    generally 
admitted.' 

insanity      A  MAN  whose  conscious  mind  is  diseased  is  called 
of  con-Bease  insane  ;  but  one  whose  '  unconscious  mind  '  is  affected 


mind9         ^8  no^  regarded  as  insane  but  as  '  hysterical,'  which  to 

hysteria      S0me  is  a  worse  name  than  the  other.     The  delusions 

conscious,    may  be  equally  strong  in  both  cases  and  the  results 

on  life  almost  as  disastrous,  and   yet   we  are  quite 

clear   that   a   man   is   not  insane  if    he    has  only 

'hysteria.'     This  nomenclature  should  not   be   dis- 

turbed, and  the  word  '  insanity  '  should  not  be  allowed 

to  cover  any  disorders  below  consciousness.     In  the 

present  instance  we  have  nothing  to  do  with  diseases 

of  the  conscious  mind,  and  I  do  not  therefore  write  of 

the  insane  at  all.     Nor,  on  the  other  hand,  are  we 

here  confined   to  hysteria.     Our  general  subject  is 

Functional  *  the  mental  factor  in  medicine,'  and  what  we  must 

afs'eTses      consider  now  is  the  special  bearing  of  this  factor  on 

recently      functional  nerve  diseases.     It  is  only  of  recent  years 

recognised,  that  these  diseases  have  been  recognised  as  such,  and 

given  a  distinct   place   by  the  profession   generally. 

Pioneers  and  geniuses  in  medicine  told  us  all  about 

these  diseases  long  ago,  but  we  heeded   them  not. 


FUNCTIONAL  NERVE  DISEASE  99 

Now  we  unearth  the  musty  tomes,  and  are  surprised 
to  find  what  modern  views  those  medical  classics 
contain. 

Hospital  students,  again,  are  generally  kept  abreast 
of  the  most  recent  advances,  and  are  pretty  well  up  medical 
to  date  in  their  knowledge ;  and  yet  it  is  only  quite  educatlon> 
recently  that  this  subject  has  occupied  a  definite  place 
in  their  education  ;  and  though  the   sufferers  from 
this  form  of  disorder  exist  in  ever-increasing  numbers, 
it  still  brings  up  the  rear  in  the  ranks  of  disease. 
I     must    here    utter    a    word    of    protest    against  Sometimes 
the  contempt  with  which  the  ignorant  public — and  with  con- 
shall  we  say  at  times  semi-ignorant  medical  men  ? —  fcempt 
regard  functional  nerve  disease.     The  word  '  hysteria ' 
is  generally  uttered  with  great  contempt,  and  is  often 
treated  as  if   synonymous   with  malingering.     In  a 
recent  medical  work  we  read  :  '  The  sister  of  the  ward 
and  the  house  physician  settled  between  them  that  True 
the  case  was  hysterical  and  the  girl  was  malingering ; ' 
that   is,   that   hysteria   means   shamming.     Such  a 
statement  takes  us  back  to  the  Dark  Ages,  when  all 
insanity  was  possession  by  an  evil  spirit ;  as  it  certainly 
implies  that  one  with  serious  nerve  disease  is  simply 
possessed  by  a  lying  spirit.     'A  disease  due  to  the 
imagination  is  not '  (as  we  shall  see)  '  an  imaginary 
disease,'  but  can  produce  functional  and  even  organic 
disturbances.     The  late  Dr.  Sutton  once  said  to  me 
with  great  force :  '  If  a  man  is  so  ill  as  to  say  he  is 
ill  when  he  is  not  ill,  he  must  be  very  ill  indeed.' 

Dr.  Clouston  makes  some  important  remarks  on 
the  subject.  He  says  : l  '  If  some  people  want  to  imply  reproach, 
that  a  patient's  symptoms  are  unimportant,  they  call 

1  Dr.  Clouston,  British  Medical  Journal,  January  18, 1896. 


100  THE  FOBCE  OF  MIND 

them  "  nervous  ;  "  if  they  want  to  ticket  them  as  un- 
worthy of  consideration  altogether,  they  call  them 
"  mental ;  "  and  if  they  want  to  brand  them  as  quite 
absurd  and  out  of  the  pale  of  human  sympathy  or 
medical   effort,  they  call   them  "  hysterical."      One 
would  imagine  from  these  things  that  the  phenomena 
of  sensation — normal  and  abnormal,  and  those  of  con- 
sciousness— feeling,  judging,   willing,   and   memory 
and  their  disturbances  through  cortical  disease,  were 
not  comprehended  in  true  scientific  work  at  all ;  and 
Mind          that  mind  generally  and  nervous  influence  might  be 
inSSe6     ^e^  ou*  °*  account  by  the  physician  !     A  man  breaks 
account       ni8  ieg    an;j  it  is  aa>i&  to  be  put  up  on  "  scientific 

with  some.          .       .  .  . 

principles."  He  loses  his  memory,  his  energy  of  will, 
his  social  instincts,  and  in  the  diagnosis  and  treat- 
ment of  his  disease  the  word  "  scientific  "  is  exchanged 
for  terms  which  are  often  vague  and  meaningless.' 
It  seems  to  me  that  the  severity  of  these  scathing 
remarks  is  quite  justified  by  their  accuracy  and  un- 
deniable truth. 

imaginary         Up  to  fifty  years  ago  doctors  failed  to  distinguish 
an"!*86       between  an  imaginary  disease  and  a  disease  of  the 
disease       imagination,  and  airily  dismissed  both  as  malinger - 
imagina-      ing.     No  suspicion  seems  ever  to  have  entered  their 
minds  as  to  the  root  error  they  were  making,  and  the 
disastrous  consequences  for  which  they  were  surely 
The  one      responsible.     It    never  occurred  to    them  that    an 
exi^the     imaginary  disease  was  a  disease  a  person  had  not  got; 
others  do.    but  a  disease  of  the  imagination,  on  the  contrary,  was 
a  disease  the  person  had  got.  Once  this  is  fairly  under- 
stood, and  we  thoroughly  and  clearly  grasp  that  a 
disease  of  the  imagination  only  differs  from  a  disease 
of  the  lungs  in  being  more  obscure  and  difficult  to 


FUNCTIONAL  NEEVE  DISEASE          101 

treat,  that  it  probably  causes  more  suffering,  and  may 
end  in  death,  we  are  up  to  date,  at  any  rate,  in  this 
matter.  Archaic  survivals  (early  Victorian),  however, 
everywhere  abound,  to  whom  the  above  is  utterly 
futile  —a  playing  with  expressions,  and  a  trifling  with 
the  word  '  disease.'  I  do  not  defend  the  term 
'  imagination  '  or  '  imaginary  '  as  scientific.  Indeed, 
I  defend  no  term  I  have  used  on  this  ground.  It  is  Terms  of 
best  at  present  to  regard  all  expressions  connected 
with  mind  and  psychoses  and  neuroses,  and  disease 
also,  as  only  provisional  '  terms  of  expectation.' 

I  believe  that  all  functional  diseases  have  some- 
where  an  organic  basis  as  well  as  a  mental ;  and  like-  have  an 
wise  that  all  organic  diseases  have  a  functional  as  bS"3 
well  as  a  mental  factor ;  in  fact,  may  we  not  say  that, 
so  far  as  our  present  knowledge  extends,  no  operation 
goes  on  in  man  in  health  or  disease  without  the  com- 
bined action  in  some  way  of  mind  and  body  ? 

Still,  the  organic  is  often  as  difficult  to  trace  as  the  Organic 

~    ,.  j.  ,       basis  often 

mental   factor.     Ordinary  mentation  can  never  be  hard  to 
explained  by  organic  changes,  but  doubtless  physio- 
logical  and  anatomical  changes  may  explain  many  of 
its  morbid  phenomena. 

The  subjects  of  functional  nerve  disease  are  by  no 
means  always  drawn  from  the  same  class,  either  paths, 
mental,  moral,  or  physical.  We  find  sufferers  amongst 
the  greatest  and  the  least,  the  noblest  and  the  basest, 
the  strongest  and  the  weakest,  amongst  men  and 
women.  The  same  elements,  after  all,  exist  in  great  men 
and  neuropaths  ;  only  in  the  former  there  is  power  to 
subordinate  the  means  to  the  end,  and  to  keep  the  idea 
noble  and  the  habits  excellent.  Nervousness,  after  all, 
is  an  excess  of  self-consciousness  of  a  normal  quality. 


102  THE  FOKCE  OF  MIND 

Hereditary  The  evil  consists  in  bringing  into  consciousness 
neuroses.  ^hat  should  be  left  in  unconsciousness.  It  may,  of 
course,  be  more  than  this,  but  this  at  least  is  ever 
present.  There  is  generally,  also,  a  predisposition 
both  from  temperament  and  heredity.  Dr.  Eennie 
points  this  out 1  and  asks  us  to  recognise  the  moral  and 
emotional  side  of  human  nature,  particularly  in  young 
women,  and  observe  how  frequently  it  is  a  cause  in 
hysteria.  He  also  reminds  us  that  the  offspring  of 
persons  who  are  alcoholic,  or  insane,  or  neurotic  fre- 
quently inherit  nervous  systems  which  are  unstable, 
and  furnish  us  with  illustrations  of  defective  and 
perverted  functional  nervous  activities. 

Dr.  Dr.  Clouston  furnishes  us  with  an  illustration  or 

S°nervou»  two  °*  Buc^  cases-  He  says  : 2  '  Here  is  a  woman  with 
diathesis,  well-marked  features  of  the  nervous  diathesis,  which 
is  usually  characterised  by  medium  stature,  small 
muscular  development,  spare  habits,  features  marked 
and  expressive,  muscular  movements  in  health  abrupt 
and  energetic,  sensory  power  keen,  reactive  power  to 
impressions  from  within  and  from  without  quick  and 
intense.  Your  patient  has  the  looks  and  the  asexual 
shape  of  the  climacteric  on  her.  But  she  has  a  hope- 
less, fearful,  depressed  expression  of  eye,  the  skin  is 
muddy,  and  the  attitude  and  movements  show  a  lack 
of  nervous  force. 

Thementai         '  Before  she  has  said  six  sentences  you  see  that  she 

dTtSmTiTe7   suffers  from  climacteric  melancholia,  one  of  the  in- 

«8e»Te     numerable  neuroses  that  arise  primarily  out  of  the 

nervous  diathesis  ;  secondarily,  from  the  great  epochs 

of  life  ;  and,  lastly,  from  ordinary  exciting  causes  of 

1  G.  E.  Bennie,  British  Medical  Journal,  May  4,  1901. 
*  Dr.  Clouston,  British  Medical  Journal,  January  18, 1896. 


FUNCTIONAL  NEEVE  DISEASE          103 

disease.  Why  does  one  man  develop  tertiary  syphilitic 
disease  of  the  nervous  centres,  or  have  locomotor 
ataxia,  or  Jacksonian  epilepsy,  or  local  paresis,  or 
cerebral  syphilomata,  while  nine-tenths  of  the  other 
men  who  have  tertiary  syphilis  develop  its  symptoms 
in  the  bones  and  joints  and  skin  ? 

'  Because  he  has  a  nervous  diathesis  or  neurotic 
constitution,  no  doubt,  which  means  that  all  causes  of 
disease  are  attracted  to  his  nervous  tissues. 

'  His  brain  cortex  is  his  weak  point.  When  he  be-  Picture  of 
comes  tired  he  is  irritable,  sleepless,  and  perhaps  craves  ^^^ 
for  alcoholic  stimulants,  which  affect  him  strongly.  diathesis.' 

'  When  he  has  losses,  misfortunes,  or  worries,  they 
exhaust  his  nervous  energy  unduly  and  paralyse  his 
volitional  power,  so  that  he  is  utterly  cast  down. 

'  When  he  marries  he  probably  indulges  in  sexual 
intercourse  to  an  inordinate  and  hurtful  extent.  When 
he  is  reduced  by  ordinary  disease,  he  becomes  sleep- 
less, dyspeptic,  nervous,  or  neurasthenic.  When  he 
is  getting  old,  he  fails  in  memory  and  in  energy  all 
at  once.  If  predisposed  specially  to  mental  disease  as 
well  as  being  generally  neurotic,  any  one  of  those  re- 
ducing causes  which  I  have  mentioned  may  bring  on 
an  attack  of  melancholia  or  mania.  When  he  has 
influenza,  it  attacks  specially  his  brain  cortex,  and  he 
is  never  the  same  man  again.' 

Clinically,  Dr.  Clouston  recognises  four  types  of  J^jj"1 
functional  nerve  disease :  disease. 

1.  Feigned  disease  (or  malingering). 

2.  Functional  disease  dependent  upon  (obvious) 
organic  disease. 

3.  Neurasthenia. 

4.  Hysteria. 


104  THE  FOECE  OF  MIND 

The  first  I  do  not  speak  of  here,  the  second  occu- 
pied us  in  the  last  chapter,  and  the  third  and  fourth 
we  will  now  consider. 

Near-  Neurasthenia  simply  means  nerve  weakness.     The 

asthenia.     term   itgelf  wag  uniinown  ^  England  before  1886, 

though  used  earlier  in  America  and  Germany.  This 
disease,  in  common  with  other  nerve  troubles,  has 
been  somewhat  in  the  condition  of  Noah's  dove  at 
least  as  described  in  poetry ;  for  it  has  long  '  flitted 
between '  the  '  rough  seas '  of  ordinary  medical  prac- 
tice and  the  '  stormy  skies '  of  the  alienist,  seeking 
in  vain  a  resting-place  for  the  sole  of  its  foot.  It  was 
neither  physical — so  the  physician  would  have  none 
of  it ;  nor  (consciously)  mental  —  so  was  looked  on 
with  suspicion  by  the  alienist ;  and  it  was  long  in  a 
France  and  parlous  state.  Indeed,  were  it  not  for  the  well-known 
befriended  gallantry  of  the  two  great  nations  of  America  and 
astiienics  France  towards  sufferers  (mainly)  of  the  fair  sex,  the 
lot  of  neurasthenics  would  indeed  be  hard.  Now,  how- 
ever, I  am  glad  to  say  their  claims  to  distinct  recog- 
nition as  genuine  and  reputable  sufferers  are  widely 
recognised;  and  the  respectful  attention  they  now 
receive  from  physicians  hardly  justifies  the  apologetic 
way  in  which  many  of  these  patients  still  enter  their 
consulting  rooms.  Probably  it  is  but  a  survival  of 
the  bad  old  times,  now  gone  for  ever. 

Neur-  Neurasthenia,  says  Allbutt  boldly,  '  is  neither  a 

•"dfetfoei     sham  nor  a  figment.    It  is  no  mere  hotchpotch  into 
disease.       which  odds  and  ends  of  nerve  troubles  are  thrust.' 

It  consists  broadly  of  increased  reflex  irritation 
coupled  with  a  diminished  power  of  resistance  to  pain 
and  depressing  influences.  It  is  a  rare  disease  in  the 
very  young  or  very  old,  but  common  in  middle  life. 


FUNCTIONAL  NEEVE  DISEASE          105 

Neurasthenia  used  to  be  called  hypochondriasis,  Neur- 
being  of  course  put  down  at  first  to  that  long-suffering  no?hypo- 
organ  the  liver.     The   term  'hypochondria'  is  now  chondria- 
reserved  for  a  fixed  delusive  idea  of  some  particular 
disease  or  local  suffering.     Herman  defines  it  as  '  the 
belief  without  cause  of  serious  bodily  disease.'     This 
brings  it  very  near  hysteria,  which   is  largely  the 
nervous  mimicry  of  disease. 

Neurasthenia  and  hysteria  may  of  course  coexist ; 
the  former  is  decidedly  more  common  in  men  than 
the  latter. 

There  are  many  varieties  of  neurasthenia.     When  Varieties 
the  chief  trouble  is  in  the  head,  we  speak  of  cerebral  asthenia 
neurasthenia  ;  when  it  is  in  the  spine,  of  spinal  neur- 
asthenia.    In  some  the  abdominal  viscera  are  affected, 
and  this  is  visceral  neurasthenia.     In  others  a  very 
common  form  is  sexual  neurasthenia,  and  these  are 
often  considered  the  most  incurable,  and  are  certainly 
the  most  troublesome  to  deal  with. 

Some  of  these  cases,  especially  the  last,  are  often 
perilously  near  the  shadowy  line  that  separates  the 
sound  from  the  unsound  mind. 

Cardiac  neurasthenia  is  yet  another  variety.  Here 
the  heart  is  often  painful — a  sort  of  pseudo-angina. 
The  pulse  is  rapid  in  the  surface  arteries,  and  there  is 
a  marked  loss  of  compensation  for  gravity,  as  in  the 
upright  position.  In  these  cases  the  pulse  will  be 
often  76  lying  down,  while  it  may  reach  116  in  the 
standing  position,  an  increase  of  40  beats. 

The  classes  of  neurasthenics  vary  as  much  as  the  Three 

classes  of 

varieties  of  neurasthenia.      There  are  three  classes  neur- 
clinically  constantly  observed— the  patients  who  look  aBthenio>< 
perfectly  well   and  are  cheerful,   the  nervously  ill 


106  THE  FOKCE  OF  MIND 

and  wretched,  and  the  mentally  ill  and  gloomy.  The 
first  class  are  well  nourished,  plump,  restless,  and 
talk  without  ceasing  ;  but  the  other  two  are  downcast, 
and  the  latter  especially  will  hardly  speak.  Idlers 
are  nearly  invariably  neuropaths,  and  need  equal 
treatment  for  body  and  mind.  This  is  generally 
successful,  if  these  idlers  are  men  of  capacity. 

De  Fleury  observes :  '  Slothful  neuropaths  when 
they  are  resourceful  form  the  nursery  of  great  minds. 
Amongst  this  class  were  Alfieri,  J.  J.  Kousseau, 
Goethe,  who  could  all  only  work  a  few  hours  a  day. 
Also  Darwin,  Balzac,  Zola,  who  can  only  write  three 
hours  a  day.' 

Cansea  The  causes  of  neurasthenia  are  innumerable  ;  but 

asthenia,  ^ne  cnie^  predisposing  cause  is  a  weak  nervous  system 
through  heredity  or  want  of  nutrition,  and  the  chief 
exciting  cause  is  over-strain. 

In  education  the  true  chronological  order  is  the 
body  first,  and  the  brain  after.  Neglect  of  this  is 
a  large  factor  in  this  disease. 

Education  Many  cases  of  neurasthenia  are  put  down  to 
Mthenia*  education ;  but  we  must  remember  that  development 
of  the  nervous  system  makes  for  increased  control. 
It  is  found  by  Dr.  Allbutt  that  neurasthenics  are,  after 
all,  not  more  common  in  New  York  than  London,  or 
among  the  busy  than  the  idle.  The  disease  abounds 
in  such  places  as  Finland,  and  in  the  Yorkshire 
collieries. 

Nervous  Dr.   Allbutt,  however,  goes  on  to   say  :  l     '  The 

majebetoo  attributing  of  over-excitability  to  nerve   structures 

1  excitable.'  m  (jigease  js  absurd.     No  nervous  matter  was  ever  too 

excitable.     To  be  excitable  is  its  business.     In  over- 

1  Dr.  Clifford  Allbutt,  System  of  Medicine,  viii.  150. 


FUNCTIONAL  NEKVE  DISEASE          107 

irritability  a  racehorse  differs  from  a  jackass.  The 
more  excitable  our  nerves,  the  quicker  and  higher 
our  life.'  But  here  surely  Dr.  Allbutt  says  too  much* 

Within  the  limits  of  perfect  control,  it  is  possible 
that  the  nervous  system  cannot  be  too  excitable,  but 
surely  the  safety  lies  in  the  italicised  addition  we  have 
suggested.  Other  things  being  equal,  the  more  ex- 
citable, the  fiercer  the  combustion,  the  more  rapid  the 
metabolism,  the  more  necessary  the  strong  control. 
A  slow-combustion  stove  needs  neither  the  attention 
nor  the  care  that  a  forced-draught  boiler  does ;  and 
speed  seldom  increases  safety. 

It  is  of  course  difficult  to  define  the  point  at  which  Mental 

strain,  ft 

life  at  high  pressure  or  hard  study  or  training  ceases 
to  do  good  and  begins  to  do  harm  to  the  nerve  centres. 

'  Mental  strain,'  Sir  James  Paget  points  out,  '  is 
a  common  cause  of  nerve  disease  ; '  and  he  instances  a 
case  of  paraplegia  following  a  severe  Civil  Service 
examination. 

Karl  Petren,  of  Upsala,  in  the  Deutsche  Zeitschrift 
fur  Nervenheilkunde,  Bd.  xvii.,  reports  the  results  ob-  and 
tained  in  a  recent  investigation  upon  the  frequency  of  * 
neurasthenia  in  the  various  grades  of  society.  Con- 
trary to  usual  statements,  he  does  not  find  a  larger 
number  of  cases  in  the  upper  than  the  lower  classes. 
Out  of  some  2,478  patients  observed  between  1895  and 
1899,  he  met  with  285  (11-5  per  cent.)  cases  of  definite 
neurasthenia.  These  he  resolves  into  three  groups : 
(1)  Artisans  and  peasants ;  (2)  tradesfolk  and  under- 
officials  ;  (3)  intellectuals.  In  further  division  as  to 
sex,  males  are  easily  first  with  (1)  14-8  per  cent.,  (2) 
18-2  per  cent.,  (8)  13-3  per  cent.  As  regards  women, 
the  numbers  are  (1)  11-4  per  cent.,  (2)  6-6  per 


108  THE  FOECE  OF  MIND 

cent.,  and  (3)  6'6  per  cent.  In  Sweden  it  therefore 
now  appears  that  neurasthenia  is  more  prevalent 
amongst  the  working  classes.  Petren  thinks  that  as 
previous  writers  have  drawn  their  statistics,  on  the  one 
hand,  from  the  higher  classes,  and,  on  the  other, 
from  clinics,  the  results  disagree  because  many 
neurasthenics  do  not  come  under  hospital  treatment, 
while  those  of  the  former  status  readily  consult  their 
doctors.  That  the  disease  is  not  dependent  upon 
the  rush  of  modern  life  seems  apparent  from  the  fact 
that  the  greater  number  of  cases  came  from  the  pro- 
vincial parts  of  Sweden,  where  life  is  very  simple  and 
Classifies-  tranquil.  As  regards  causation,  62  cases  have  fol- 
Sus2.  lowed  family  disappointments,  24  financial  difficulties, 
and  47  overwork.  Twenty-nine  cases  occurred  after 
influenza,  21  acknowledged  venery  or  masturbation ; 
in  16  females  it  complicated  pregnancy  and  the  puer- 
perium,  8  were  directly  traced  to  alcoholic  excesses, 
and  2  were  produced  by  high  temperatures  experienced 
during  their  avocation.  A  prominent  factor  is  that  of 
hereditary  alcoholism.  In  the  early  years  of  the 
century  large  quantities  of  spirits  &c.  were  almost 
universally  consumed,  and  where  the  alcoholic  ten- 
dency is  not  directly  apparent  its  influence  is  felt  in 
the  nervous  equilibrium  of  the  present  generation. 
Several  cases  are  reported  in  which  cerebral  arterio- 
sclerosis was  present.  Hygienic  conditions  also  con- 
tribute to  the  increase  amongst  the  lower  classes. 
Lack  of  proper  nourishment,  insanitary  dwellings,  and 
monotony  of  existence  are  amongst  some  of  the  causes 
that  need  attention  in  order  to  prevent  its  further 
extension. 

The  mental  factor  in  neurasthenia  is  sufficiently 


FUNCTIONAL  NEEVE  DISEASE  109 

obvious,  but  there  is   also   the  physical  factor,  just  Physical 
pointed  out  by  Karl  Petren,  of  malnutrition,  which  ^^  m 
is  common  enough  ;  or  of  some  chronic  and  depressing  asthenia' 
disease,  of  persistent  physical  pain,  or,  on  the  other 
hand,  mental  pain,  as  in  constant  unhappiness. 

It  may  arise,  again,  from  shock  or  an  operation  ; 
or  be  left  as  a  legacy  after  disease,  and  particularly 
after  influenza. 

Neurasthenia  often  arises  in  men  from  sexual  Sexual 
excesses  ;  in  women  more  commonly  from  the  strain 
of  sexual  life  in  child-bearing,  &c.  Herman  l  points 
out  that  '  the  Protean  symptoms  of  Bennet,  Tilt, 
and  Graily  Hewitt,  described  by  them  as  being  of  a 
reflex  nature  from  minor  diseases  of  the  uterine 
organs,  really  arise  from  the  mind.  It  is  not  that  a 
cervical  erosion  hurts  the  nervous  system,  but  that  a 
weak  nervous  system  draws  attention  to  the  cervix. 
Nervous  women  as  a  class  resist  pain  badly,  and  feel 
it  more  acutely.  Still,  though  mental  in  origin,  these 
Protean  (really  neurasthenic)  symptoms  are  benefited 
by  local  treatment.  Diseases  of  the  womb  may 
aggravate  neurasthenia,  but  do  not  cause  it  per  se.' 

Turning  to  the  symptoms  of  neurasthenia,  we  had  Sym 


better  give   first   the  complete  list  as  enumerated  asthenia. 
by  Dr.  Beard,  of  New  York,  a  man  of  very  great  J£tBeard>* 
experience  in  the  disease.     It  need  hardly  be  said 
that  no  single  case  exhibits  even  one  half  of  these 
symptoms. 

Scalp  tenderness—  headaches  (not  in  my  expe- 
rience a  common  or  a  prominent  symptom)  —  dilated 
pupils—  feeling  of  pressure  on  the  vertex  —  heavy 
expression  of  eye  —  congested  conjunctivse  —  alteration 

1  G.  Herman,  Diseases  of  Women,  p.  11. 


110  THE  FORCE  OF  MIND 

of  the  nerves  of  special  sense  (increased  or  diminished 
capriciously) — muscse  volitantes— noises  in  the  ears — 
atonic  voice — loss  of  mental  control — irritability — 
hopelessness — morbid  fears  of  open  places,  of  crowds, 
of  confined  spaces,  of  being  alone,  of  people,  of 
responsibilities,  of  diseases,  of  infection,  of  trains  or 
cabs,  of  everything  (called  by  various  Greek  and 
other  compound  words,  agoraphobia,  claustrophobia, 
&c.  &c.) —blushing — insomnia  (a  marked  symptom) — 
drowsiness  (in  visceral  neurasthenia) — tender  teeth- 
dyspepsia— love  of  drugs — abnormal  secretions — 
sweating  hands — tender  spine — tender  coccyx — irri- 
table heart — tremors— dysphagia— irritable  cough — 
irregular  respiration  (sometimes  '  Cheyne  Stokes ') — 
cramps  —  morbid  sensibility  —  numbness  —  hyper- 
sesthesia— exhaustion— pruritus  —  flushes  —  cold  feet 
and  hands—  sudden  changes  of  condition  and  symptoms. 
Some  To  this  long  catalogue  we  may  add  from  personal 

additions,  experience  :  Constant  restlessness— defective  memory 
-  dizziness  and  giddiness — dread  of  noise  or  light — 
loss  of  voice — loss  of  sense  of  proportion,  small  things 
looking  big,  and  important  things  trifling— want  of 
co-ordination — palpitation  of  the  heart — weariness  of 
brain — pins  and  needles  in  limbs — left  sub-mammary 
pain— left  inguinal  pain — nervous  hand  (flexed  wrist, 
extended  fingers,  fine  tremors  and  dropped  thumb)  — 
flatulence  and  constipation. 

classifies          Out  of  the  above  48  symptoms  we  may  class  26  as 
symptoms    functi°nal>  15  as  mental,  and  7  as  physical  or  to  a 

certain  extent  organic. 

state  of  The  condition  of  the  mind  is  a  potent  cause  of 

cause  and    neurasthenia,  as  well  as  being  a  result  of  it ;  so  that 
result  of      foQ  mentai  factor  is  prominent  all  through.     It  is  for 

asthenia. 


FUNCTIONAL  NERVE  DISEASE          111 

this  reason  that  we  go  more  fully  into  functional 
nerve  diseases  than  into  others.  We  shall  grasp  the 
true  inwardness  of  this  class  of  ailment  better  when 
we  come  to.  treatment ;  for  this  throws  further  light 
on  the  aetiology,  with  which  we  have  specially  to  do 
here. 

In  the  next  chapter  we  turn  to  a  different  class  of 
case  altogether  in  hysteria  and  neuromimesis,  where 
the  most  important  part  is  not  played  by  the  conscious 
mind,  but  the  unconscious. 


112  THE  FOKCE  OP  MIND 


CHAPTEK  VII 

THE  ETIOLOGY  OF  HYSTERIA 

•  The  mental  factor  in  hysteria  is  the  unconscious 
mind.' 

That  ™-  '  HYSTERIA  '  is  an  unpleasant  and  an  unsatisfactory 
wordan  ;  word,  owing  to  its  connections  and  derivation.  No  one 
knows  exactly  what  it  means,  save  that  it  implies  some- 
thing to  be  ashamed  of.  It  is  inextricably  confused 
and  confounded  with  malingering,  neuromimesis,  all 
sorts  of  neurasthenia,  and  hypochondria. 

almost  So  keenly  is  the  word  resented  by  a  large  section 

slander*.8  *°  °f  ^ne  public  that,  though  it  may  hardly  amount  to 
libel  or  slander,  a  doctor  who  uses  it  incautiously  will 
soon  feel  the  effect  in  his  practice.  I  have  already 
indicated  in  the  previous  chapter  how  the  word  is  con- 
stantly used  for  malingering.  On  this  head  Dr.  Eennie 
Sntt"*  8a^s :  1  'Hysteria  may  assume  a  great  variety  of  forms 
'sham-  — in  fact,  there  is  no  organic  disease  of  the  nervous 
system  which  it  may  not  counterfeit.  Now  note  par- 
ticularly that  while  I  say  "  counterfeit,"  I  do  not 
wish  to  imply  that  this  is  done  intentionally  by 
the  patients  themselves  ;  and  this  class  of  patients 
must  not  be  included  in  that  of  the  malingerers  or 
feigners  of  disease.  It  is  very  important  for  you  to 

'  Dr.  G.  E.  Rennie,  British  Medical  Journal,  May  4,  1901. 


THE  ETIOLOGY  OF  HYSTEEIA  113 

remember  this,  as  there  is  too  great  a  tendency  to 
look  upon  any  case  of  doubtful  or  obscure  nerve  dis- 
ease occurring  in  young  women  as  one  of  deliberate 
shamming,   and   the  methods   of  treatment  adopted 
often  support  this  view.     I  would  advise  you  never  Dr. 
to  use  the  term  "  hysteria  "  either  to  patients  or  their  B0^me " 
friends,  because  this  word  is  synonymous  with  sham-  advice, 
ming  in  the  minds  of  the  majority  of  lay  people. 
Hence  it  is  always  better  to  speak  of  the  condition  as 
one  of  functional  disturbance  of  the  nervous  system.' 

The  words  in  the  above  which  I  have  placed  in  H  steria  fa 
italics  show  how  clear  the  belief  is  in  those  competent  »  disease 
to   speak,   that   •  hysteria '   is   not  a  disease  of  the  consclou" 
conscious    mind— its  phenomena   therefore  are  not  mmd* 
'intentional.'      But   they  have  all  the  qualities  of 
mental   and   intelligent   actions.      What  alternative 
remains,  therefore,  if  there  be  no  '  unconscious  mind '  ? 
This  is  one  of  the  many  facts  that  prove  the  existence 
of  a  faculty  of  which  we  are  not  conscious,  and  demon- 
strate the  existence  of  an  unseen  mind  by  its  products. 

Dr.  M.  H.  Jones,  however,  speaks  of  '  voluntary  There  i§ 
hysteria.'     We  may  say  broadly  that  such  a  disease  £° volun 
is  not  hysteria  but  malingering.     The  essence  of  the  hysteria 
true  disease,  we  repeat,  is  that  it  is  of  unconscious  and 
involuntary  origin,  being  a  disease  of  the  unconscious 
mind. 

Herman  goes  so  far  as  to  say  : l  '  Another  popular 
idea  is  that  "  hysterical "  means  shamming.  This  is 
true  of  the  nervous  mimicries,  but  not  true  of  the 
hysterical  paroxysm '  !  (The  italics  are  mine.)  It 
would  seem  that  this  implied  that  half  the  symptoms 
are  malingering,  and  half  due  to  the  disease. 

1  Dr.  G.  E.  Herman,  Diseases  of  Women,  p.  34. 

i  2 


114  THE  FOKCE  OF  MIND 

I  do  not  doubt  that  amongst  hysterics  may  bo 
found  malingerers  as  well,  of  whom  the  above  may  be 
true ;  but  thus  to  describe  hysterics  in  general  is  in- 
correct. It  is,  indeed,  ideas  like  this  that  tend  to 
drive  the  hysterical  to  despair ;  and  we  can  hardly 
believe  that  the  writer  really  means  to  be  taken 
literally.  Of  course,  as  we  shall  see,  where  the 
unconscious  mind  is  unknown,  ignored,  or  denied, 
'hysteria'  must  mean  '  shamming'— fits  and  all. 
Mimicries  especially  must  be  frauds,  for  they  necessarily 
involve  a  mental  process,  which  must  be  performed 
consciously  if  there  be  no  unconscious  mind  action  ; 
Conscious  an(j  this  equals  fraud,  Q.E.D.  There  seems  to  be  no 
action  other  way  out,  and  every  physician  who,  as  we  say, 
fraud!8  ignores  or  denies  the  presence  of  the  unconscious 
mind  is  positively  driven,  if  logical,  to  regard  mimic- 
ries of  disease  as  fraudulent,  even  if  he  be  not  bold 
enough  to  say  so.  This  feeling  in  his  mind  must 
influence  his  bearing  and  his  practice  in  a  wrong  and 
false  direction,  and  frequently  lead  him,  with  the  best 
intentions,  to  inflict  cruel  wrongs  upon  his  sensitive 
Conscious  patients.  Even  Sir  James  Paget,  one  of  the  acutest 
notneuro-  writers  upon  this  subject  we  have  ever  had,  seems  to 
BS1B>  imply  that  the  successful  mimicry  of  disease  must  be 
produced  by  conscious  effort,  when  he  says  : l  '  Among 
the  sane  there  are  many  who  cannot  bring  about  a 
mimicry  of  disease  by  any  effort  of  imagination  or 
direction  of  the  mind.  Among  these  I  am  happy  to 
count  myself.  I  have  tried  many  times  carefully,  and 
with  good  opportunities,  but  have  always  failed.' 
This  may  be  so;  and  yet  it  is  possible  that  those 
whose  every  conscious  effort  fails  might  become  them- 

'  Sir  James  Paget,  Lectures  on  Nervous  Mimicry. 


THE  ETIOLOGY  OF  HYSTEEIA          115 

selves  victims  of  neuromimesis,  and  reproduce  with 
perfect  fidelity  the  symptoms  of  a  disease  by  un- 
conscious mental  action  that  they  are  powerless  to 
do  consciously.  Moreover,  when  these  mimicries  are 
closely  studied,  it  will  be  seen  that  many  of  them 
involve  local  changes  of  tissues  and  functions  far 
beyond  the  range  of  any  conscious  effort. 

For  this  and  other  reasons  the  word '  hysteria  '  has  'Hysteria1 
become  so  unpleasant  and  misleading  that  it  should  restricted 
be  used  as  seldom  as   possible,  and    to   this   end  I  inuse 
think  the  word  might  be  severely  restricted  to  those 
cases  described  under  this  head  by  the  most  modern 
authorities,  which  are  mainly  characterised  by  altera-  to  cases  of 
tions  in  the  field  of  vision,  by  sensations  in  various  parts  ^cious- 
of  the  body,  and  by  convulsive  attacks.   Neurasthenia  neBB- 
and  hypochondria,  at  any  rate,  should  never  be  con- 
founded with   it.      There   may  be   and   always  are 
borderland  cases  ;  but  we  should  be  clear  that  neur- 
asthenia is  not,  and  should  not  be  called,  hysteria. 

With  neuromimesis  the  case  is  more  difficult.  Uncon- 
Many  cases  of  hysteria,  clearly  marked  by  the  signs 
we  have  given,  also  mimic  various  diseases  ;  and,  on 
the  other  hand,  the  most  extensive  mimicry  of  disease 
exists  without  one  of  these  signs.  We  think  that  here, 
as  in  neurasthenia,  neuromimesis  should  be  regarded 
as  a  separate  disease  from  hysteria,  though  the  two 
may  co-exist  in  some  cases. 

This  is  our  counsel  of  perfection  for  the  future,  Here, 
and  is  supported  by  Sir  James  Paget,  who  says:1  «JJiSrii 
1  Cases  of  neuromimesis  are  commonly  included  under  jjjjj*6* 
the  name  "  hysteria,"  but  in  many  of  them  none  of 
the  distinctive  symptoms  of  hysteria  are  ever  observed ; 

1  Sir  James  Paget,  Lancet,  1873,  ii.  512. 


116  THE  FORCE  OF  MIND 

and  from  all  of  them  it  is  desirable  this  name  should 
be  abolished.' 

But  preaching  is  one  thing,  and  practising  quite 
another,  and  for  the  present  in  these  pages  one  must 
be  content  with  the  former  without  the  latter  ;  for  it 
is  clinically  convenient,  till  the  difference  is  generally 
recognised,  to  speak  of  neuromimesis  and  hysteria 
together,  both  being  diseases  of  the  unconscious  mind, 
and  content  ourselves  here  with  raising  a  protest  and 
making  suggestions  for  the  future.  As  a  matter  of 
fact,  the  remarks  I  shall  make  on  hysteria  will  apply 
far  more  to  neuromimesis,  or  the  nervous  mimicry  of 
organic  disease,  than  to  the  true  form  of  narrowed 
sensations  and  convulsive  seizures. 

The  Let  us  consider,  then,  for  a  moment  the  process 

!T»teriain    ^v  wnicn>  in  '  hysteria,'  disease  is  caused  by  mental 
action. 

In  the  first  place,  we  note  that  our  brain  not  only 
acts  by  the  will  and  by  ideas  of  which  we  are  conscious, 
but  is  continuously  vibrating  with  ideas,  memories, 
and  trains  of  thought  of  which  we  are  unconscious. 
It  is  so  even  with  regard  to  common  sensation. 
Dncon-  A  very  small  proportion  of  the  afferent  currents 

^LnTa-       arriving  at  the  brain  produce  conscious   sensations 
tiong.'         of    any    kind.      If    the    term    'unconscious    sensa- 
tion '  be  objected  to,  let  '  unconscious  irritation '  be 
substituted;    for   they  certainly  produce   the   same 
effects  on  the  unconscious  mind  which  in  the  conscious 
we  term  sensation ;  and,  furthermore,  I  have  shown 
that  sensations  can  be  produced  by  the  unconscious 
mind,  arrested  by  it,  and    can    themselves   produce 
psychical  and  physical  effects  through  its  agency. 
Professor  W.  James,  in  his '  Psychology,'  remarks  : 


THE  AETIOLOGY  OF  HYSTEEIA          117 

'  One  of  the  most  extraordinary  facts  of  our  life  is  James, 
that,  although  we  are  besieged  by  impressions  from  TnT6*1*' 
our  whole  sensory  surface,  we  notice  so  very  small  a  JJ^JJJ. 
part  of  them.  .  .  .  Yet  the  physical  impressions  which  "o"18- 
do  not  count  are  there  as  much  as  those  which  do.' 

'  For  all  these  impressions,'  says  Barrett,'  'whether 
we  are  conscious  of  them  or  not,  leave  some  mark 
behind.  They  weave  a  perceptible  or  imperceptible 
thread  into  the  fabric  of  our  life  ;  they  make  a  greater 
or  less  indent  upon  our  personality.  We  know  that 
this  is  the  case,  for  impressions  of  which  we  were 
unconscious  at  the  time  often  emerge  when  the  atten- 
tion is  withdrawn  from  things  around,  as  in  states  of 
illness,  in  dream,  or  in  reverie.' 

Dr.  Waldstein  also  says:  'There  is  hardly  a 
moment  .  .  .  when  the  nerve  endings  in  the  skin  are 
not  constantly  assailed  by  sensations  of  pressure,  of 
temperature,  of  the  flux  or  reflux  of  the  blood  supply.' 

Perhaps  an  illustration  will  help  here. 

If  you  concentrate  your  attention  on  any  part  of  ConBcions 
your  body,  you  become  aware  of  sensations  in  it  that  consoiona 
escaped  your  attention  before,  but  were  equally  then  Vl  ratloni 
present.     If  with  a  feather  I  lightly  tickle  the  back  of 
your  neck,  and  at  the  time  you  are  engaged  in  very 
earnest   conversation,   the   vibration   aroused  in  the 
brain  sensory  centre  is  unnoticed  by  you  ;  and  yet  if 
I  call  your  attention  to  the  part  it  is  noticed  at  once. 
By  increasing  the  stimulus  I  can  make  the  waves  of 
vibration   set  in  action   other   centres :   involuntary 
ones,  such  as  cause  a  shaking  or  shuddering  of  the 
neck ;  or  voluntary,  such  as  turning  the  head  round 
or  moving  away. 

1  Professor  Barrett  (Dublin),  Humanitarian,  1895. 


118  THE  FORCE  OF  MIND 

If  you  are  asleep  I  may  tickle  your  foot,  so  that 
you  draw  the  leg  away  and  you  wake  up.  In  this 
case  you  are  probably  conscious  of  moving  your  leg  ; 
but  the  stimulus  that  made  you  do  it  was  too  slight  to 
reach  your  consciousness.  We  may  thus  be  conscious 
of  a  transferred  vibration  leading  to  action  or  sensa- 
tion, and  yet  be  ignorant  of  the  cause  that  set  it  going. 
Power  of  Memories,  again,  will  involuntarily,  and  it  may  be 

unconsciously,  arouse  both  feelings  and  actions.  One 
may  have  smelt  the  strong  scent  of  some  flower  when 
some  critical  event  took  place,  a  proposal  of  marriage 
or  some  sudden  news  ;  henceforth,  whenever  the  topic 
is  touched  on,  the  very  scent  or  vibrations  of  the 
nerve  of  smell  that  represent  it  may  be  exactly  repro- 
duced. A  certain  field  always  recalls  a  certain  song 
we  used  to  sing  as  we  crossed  it  on  our  way  to  school. 
The  thoughts  of  old  Anglo-Indians  often  set  the 
vibrations  of  Eastern  sights  and  sounds  in  action  again 
in  the  old  centres. 

Observe  in   all   these   cases  we   are  considering 

natural  associations,  not  vibrations  deliberately  set  up 

by  the  will  in  an  unusual  way.    You  can,  as  shown 

already,  think  of  a  green  field  when  in  a  drawing-room 

until  you  set  in  vibration  the  centre  of  sight  and  see 

the  green  grass ;  or  the  centre  of  hearing,  and  hear 

the  lowing  of  the  cattle  or  the  hum  of  the  hi  sects. 

This  is  much  easier  if  there  are  no  distracting  sounds, 

and  if  you  close  your  eyes  ;  and  still  more  so  if  there 

are  some  insects  actually  humming  in  the  room.     But 

the  memories  I  speak  of  are  wholly  unconscious  ones. 

Seat  of  ail         Let  us  now  sum  up  our  results,  taking  a  definite 

la  itTthe18    case>  sav  °f  a  Pain  m  the  little  finger.     This  pain  is 

brain.         felt  in  the  little  finger,  we  say,  though  we  really  know 


THE    ETIOLOGY    OF    HYSTERIA          119 

that  the  only  seat  of  any  sensation  is  in  the  brain.  It 
is  there  at  the  central  termination  of  the  ulnar  nerve 
which  leads  from  the  little  finger  that  all  the  vibra- 
tions take  place,  of  which  the  mind  becomes  conscious 
and  which  it  calls  pain.  Whenever  these  vibrations 
take  place  in  the  nerve  centre  belonging  to  the  little 
finger  in  the  brain,  the  mind  always  refers  the  sensa- 
tion to  the  commencement  of  the  nerve  in  the  little 
finger,  whatever  may  be  its  real  origin. 

In  the  same  way,  if  in  your  house  the  hall-door  We  think 
bell  rings,  you  say  there  is  some  one  at  the  hall  door ;  injured*  * 
if  the  drawing-room  bell,  there  is  some  one  there ;  spott 
and  yet   such   may  not   be  the  case.    I  may  have 
pulled  the  door-bell  wire  inside  the  hall,  as  I  passed 
down  the  kitchen  stairs ;  or  a  rat  may  have  moved  it, 
or  I  may  have  struck  the  bell  itself  and  made  it  ring, 
or  a  shock  of  earthquake  may  have  shaken  it,  or  a 
strong  gust  of  wind  ;  and  yet,  although  these  causes 
are   so   various,   you,   in   the   kitchen,   always   say, 
1  There  is  some  one  at  the  front  door.' 

It  is  so  in  the  body.  1.  The  little  finger  is  pricked  Pain  IB 
— there  is  pain  in  the  little  finger.  2.  The  ulnar  nerve 
itself  is  pressed  on  somewhere  in  its  course— there  is 
pain  in  the  little  finger.  The  hand  may  be  cut  off,  nerve» 
and  still,  if  the  nerve  be  irritated  in  the  stump  by 
pressure,  the  man  feels  the  pain  in  his  imaginary 
little  finger  as  truly  and  vividly  as  if  it  were  still 
actually  there.  3.  Or,  again,  there  may  be  a  tumour 
in  the  brain  pressing  on  the  nerve  centre  in  the  brain 
of  the  ulnar  nerve,  and  the  most  acute  pain  is  felt  in 
the  little  finger. 

All  these  instances  are  from  direct  irritation  of  the 
nerve  in  some  part  of  its  course.     But,  as  we 


120  THE    FOBCE    OF    MIND 

seen,  we  may  go  much  further.  The  hall-door  wire 
may  have  got  caught  with  the  drawing-room  one,  so 
that  when  the  latter  is  pulled,  it  is  the  hall-door  bell 
that  rings  ;  the  vibration  is  thus  transferred.  So  in 
however  it  the  brain.  4.  I  may  set  to  work  to  think  of  my 
caused5  little  finger,  and  so  start  sensations  in  it  which,  if 
not  actual  pain,  are  still  sensations.  .But  if  I  have 
the  idea  it  is  injured,  though  it  may  not  be,  I 
may  feel  the  pain  acutely  from  an  idea  alone. 
6.  But,  again,  the  pain  may  have  been  originally 
caused  by  an  abscess  in  the  little  finger,  and  after- 
wards kept  up  long  after  the  abscess  was  gone,  by 
the  ideal  centre.  6.  Association  may  cause  pain,  as 
seeing  others  with  crushed  little  fingers;  or,  7. 
Memories,  conscious  or  unconscious,  of  crushed  little 
fingers  may  also  start  and  keep  up  this  pain. 

Observe,  then,  the  varied  causes  with  the  same 
effect.  Only,  in  conclusion,  we  may  add  that  while 
in  health  it  is  generally  easy  to  discriminate  between 
pain  in  the  little  finger  caused  by  injury  to  the  little 
finger,  and  that  set  up  in  other  ways,  in  nerve  disease 
it  is  not.  Nay,  it  is  sometimes  impossible  not  only  to 
the  sufferer,  but  to  the  doctor  who  attends  him. 


and  we  feel  think  we  feel  ;  and  we  feel  as  we  think.  If  we  feel  a 
think.  pain,  we  think  we  are  ill  ;  and  if  we  think  we  are  ill, 
we  feel  ill.'  If  my  ideal  centre  vibrates  with  the 
thought  of  crossing  the  Channel  in  rough  weather, 
and  pictures  the  nausea  that  would  then  be  felt,  the 
vibrations  are  transmitted  t.o  the  terminal  centres  of 
the  sensory  nerves  running  from  the  stomach,  and  I 
actually  feel  sick  from  communication  with  a  sensory 
centre  ;  and,  possibly,  if  of  a  highly  nervous  organisa- 


THE    ETIOLOGY    OF    HYSTEEIA          121 

tion,  may  actually  be  sick  from  transference  to  a 
motor  centre. 

Eeal  feelings  and  real  acts  can  be  started  in  Real 
entirely  ideal  centres.  If  we  think  intensely  of  any 
part  of  the  body  long  enough,  we  feel  sensations  in  j^deai 
that  part.  If  we  think  of  a  good  dinner  our  mouth 
waters.  We  shiver  whether  we  only  think  of  cold  or 
actually  feel  cold.  The  sensation  of  pain  can  be 
produced  as  really  and  vividly  by  thoughts  or  ideas 
alone,  as  light  in  the  eye  by  striking  it.  In  short, 
every  sensation  of  the  body  ordinarily  produced  from 
without  can  also  be  produced  from  within. 

These  ideal  vibrations,  acting  on  motor  and  other 
centres,  are  quite  different  from  the  action  of  a  motor 
centre  by  the  direct  impulse  of  the  will,  the  action 
being  in  the  latter  case  voluntary  and  in  the  former 
involuntary.  So  far  I  have  only  spoken  of  ideas  of 
which  we  are  conscious,  so  that,  although  the  modes 
of  exciting  these  motor  and  sensory  centres  are 
abnormal,  we  know  them  to  be  so,  and  hence  are  not 
deceived  and  do  not  deceive  others  into  believing 
them  to  be  natural. 

Thus,  when  our  teeth  are  on  edge  from  discordant  Subjects 
sounds,  we  do  not  go  to  the  dentist ;  if  we  are  sick  from  La  a 
ideas,  we  do  not  think  we  are  dyspeptic ;  if  we  hear  sound'- 
noises  in  the  ear,  we  do  not  look  for  them  externally  ; 
if  we  shiver  from  thinking  of  cold,  we  do  not  put  on 
more  clothing ;  but  this  is  because  we  are  conscious 
that  the   cause  is  mental ;   in  other  words,  of  the 
action  of  the  mind.     It  is  quite  otherwise  where  the 
sensation  is  caused  by  mind  action  of  which  we  are 
wholly  unconscious  :  the  conscious  part  of  the  mind 
being,  at  the  same  time,  cognisant  of  the  symptoms, 


122  THE    FOBCE    OF    MIND 

but  ignorant  of  the  cause,  naturally  attributes  it  to 
the  disease  most  likely  to  produce  it. 
Sensations         With  regard  to  the  excitation  of  feelings  by  the 

from  ideas  ..  «.i  -I-TITT  T 

are  not        action  of  the  mind,  John  Hunter  says  :  '  I  am  con- 
sensation.    ndent  th^  I  can  nx  mv  attention  to  any  part  until 
I  have  a  sensation  in  that  part.' 

The  transition  is  easy  from  the  irritation  of  real 
sensations  to  those  actually  produced  by  expectation 
in  the  ideal  centres,  only  we  must  remember  the  mind 
produces  sensation  by  ideas,  not  ideas  of  sensation. 
The  difference  is  enormous. 

'  Whatever  mental  or  bodily  state  can  be  excited 
through  the  senses  from  without  may  arise  from  with- 
in, from  imagination  proper.' ! 

Sensations  Braid  took  four  men  between  forty  and  fifty  years 
Han^6  of  age,  and  told  them  to  fix  their  attention  on  their 
hands  for  five  minutes.  One,  a  member  of  the  Eoyal 
Academy,  felt  intense  cold  in  the  hand  ;  an  author, 
darting  and  pricking  pains  ;  a  mayor  felt  heat ;  a 
scientific  man  had  the  arm  cataleptically  fixed  to  the 
table.2 

The  sensations  in  the  hand  by  thought  are  produced 
probably  by  real  vaso-motor  changes  in  the  hand,  set 
up  by  the  mental  excitation  of  the  sensory  centre  in 
the  brain. 

iLetSh°n8  The  sensation  of  the  teeth  on  edge  may  be  excited 
by  an  acid  on  the  teeth  (normal  irritation),  by  scraping 
glass  (transference  from  auditory  nerve,  which  lies  by 
the  side  of  the  nerve  from  the  teeth,  in  a  bony  canal), 
by  seeing  glass  about  to  be  scraped  (transference  from 
optic  nerve  by  association),  or  by  the  mere  thought  of 

1  Hack  Tuke,  Mind  and  Body,  2nd  edit.  i.  30. 
'-  Braid,  Hypnotism,  xx.  93. 


THE  ETIOLOGY  OF  HYSTEEIA          123 

it  being  done  (transference  from  ideal  centres).  In 
each  of  these  cases  the  mouth  may  be  filled  with 
saliva. 

I  have  perhaps  shown  sufficiently  the  process  by  Neuro- 
which  neuromimesis  may  be  set  up  in  a  weak  nervous  SSSSbe 
system,  and  will  now  consider  how  this  process  begins.  °n^etrfrom 
I  have  already  shown  that,  without   admitting  the  theuncon- 
existence  of  the  unconscious  mind,  it  is  difficult  to  see  ^S 
how  neuromimesis  can  be  regarded  as  a  true  disease, 
and  have  indicated  the  various  ways  in  which  sensa- 
tions  may  be  abnormally  aroused,  and  referred  to 
non-existent  causes  ;  and  I  will  now  give  some  current 
views  as  to  the  cause  of  hysteria,  hoping  to  show  that 
the  theory  that  it  is  due  to  unconscious  mind  action 
is,  after  all,  the  most  probable.     It  must  be  premised 
once  more  that  we  use  the  word  '  hysteria '  generally 
as  covering  all  forms  of  neuromimesis. 

Dr.  G.  E.  Eennie  says : l  '  Now,  there  has  been  much  Dr. 
discussion  as  to  the  nature  of  this  form  of  functional  viewST B 
nerve  disease.     There  are  some  who  would  attribute 
the   condition   to   functional   degradation   in  certain 
parts  of  the  brain  or  spinal  cord  ;  the  occurrence  of  an 
hysterical   hemianaesthesia   or  hemiplegia  would  on 
this  theory  be  due  to  some  vaso-motor  spasm  in  the 
cortical  areas  of  sensation  or  motion.     An  attack  of 
paraplegia  would  be  due  to  some  impairment  in  nutri- 
tion of  the  cells  of   the  anterior  cornua.     But  this  NO  coarse 
explanation  will  hardly  meet  all  the  facts,  since  the 
sudden  transference  of  a  hemianaesthesia  from   one 
side  of  the  body  to  the  other  under  the  influence 
of  a  magnet  or  some  special  metal  could  hardly  be 
explained  by  any  such  coarse  pathology. 

1  Dr.  G.  E.  Kennie,  British  Medical  Journal,  May  4, 1901. 


124 


THE  FOKCE  OF  MIND 


which  is 
dependent 
on  psychic 
conditions. 


Wilks, 

Ormerod, 

and 

Reynolds, 

on 

'hysteria.' 


Professor 
Janet  on 
psychic 
failure 


'  The  entirely  opposite  theory  regards  all  these 
phenomena  as  essentially  dependent  upon  psychical 
states  ;  and  functional  disturbance  or  degradation  of 
the  lower  centres  is  not  recognised.  Now,  I  think  that 
we  can  get  a  clearer  idea  or  conception  of  hysterical 
nerve  disease  by  regarding  it  as  partly  mental  and 
partly  physical ;  the  underlying  physical  state  being 
allied  to  the  hypnotic  state.' 

Sir  S.  Wilks  l  regards  hysteria  as  of  the  nature  of 
an  explosion.  He  says  :  '  Nature  having  no  outlet  for 
the  superfluous  energies,  the  whole  system  becomes 
disordered.'  Here  Nature  (our  well-known  female  deity) 
stands  for  the  '  unconscious  mind.'  Dr.  Ormerod  2 
says  vaguely  it  '  is  due  to  a  supposition  of  vaso-motor 
spasms,  or  defective  nutrition  of  nervous  elements.' 
Sir  K.  Eeynolds,  Charcot,  and  others  say  it  depends 
on  idea,  or  is  ideogenic.  These  ideas  being  uncon- 
scious, they  imply  its  origin  is  the  unconscious  mind. 

Janet  considers  '  the  anaesthesia  and  amnesia  in 
hysteria  arise  not  from  physical  failure  in  mind  or 
brain,  but  from  psychic  failure  to  grasp  or  attend  to 
sensation  ;  in  short,  a  contraction  of  the  field  of  con- 
sciousness, as  the  contraction  in  hysteria  of  the  field 
of  vision  from  the  same  cause.  The  impressions 
therefore  cease  to  rise  above  a  lower  sphere  (uncon- 
scious mind),  and  tend  to  foster  at  the  expense  of 
consciousness  a  "  secondary "  sub-conscious  mental 
state.  The  elements  of  such  a  state  exist  in  all  of  us ; ' 
and  may  I  add  that  this  state  is  here  called  the  '  un- 
conscious mind '  ? 

1  Sir  S.  Wilks,  Diseases  of  the  Nervous  System,  p.  365 ;  quoted 
by  Dr.  Herman,  Diseases  of  Women,  p.  30. 

*  Dr.  Ormerod  in  Clifford  Allbutt's  System  of  Medicine. 


THE  ETIOLOGY  OF  HYSTEEIA          125 

Professor   Biener   (Vienna)    considers '   that   the  Biener  on 
'  sundering  of  consciousness '  exists  in  rudimentary  8econ?ary 

v     conscious- 

fashion  in  every  case  of  hysteria.    The  foundation  and  ness, 
condition  precedent  to  hysteria  is  the  existence  of 
hypnoid  states  (or  what'  he  would  call  unconscious 
consciousness). 

Now  we — we  think  more  intelligibly — understand 
by  this '  sundering  of  consciousness '  the  distinction  be- 
tween the  conscious  and  the  unconscious  mind ;  and 
the  hypnoid  state  is  the  revelation  by  its  effects  of  the 
powers,  not  of  '  unconscious  consciousness,'  but  of 
the  unconscious  mind ;  while  the  consciousness  of 
the  ego  is  partly  in  abeyance  or  its  powers  impaired. 

Sir  James  Paget  says : 2  '  If  you  study  neuro-  sir  j. 
mimesis  from  its  mental  side,  you  may  easily  find 
reason  for  believing  it  [the  result  of]  mere  mental 
error,  rather  than  the  erroneous  working  of  sensory  not  be  the 
and  motor  centres  ;  but  to  regard  all  mimicries  of 
organic  disease  as  essentially  mental  errors  is  bad 
pathology  and  worse  practice.  In  some  mimicries  it 
is  hard  to  discern  any  mental  influence  at  all,  such  as 
in  distension,  constipation,  &c.  Some  are  found  in 
ignorant  and  slow-minded  people.' 

This  is  an  admirably  reasoned  passage  to  show  The  agent 
that  the  conscious  mind  is  certainly  not  the  active  Jethe nn- 
agent  in  most  neuromimetic  cases  ;  and  hence  Sir 
James,  limiting  mind  to  consciousness,  can  recognise 
no  mental  action  at  all,  and  falls  back  on  the 
erroneous  working  of  sensory  and  motor  centres. 
But  is  not  the  agent  that  sets  these  centres  working 

1  Professor  Biener  (Vienna),  Neurologisches  Centralblatt,  January 
1893. 

a  Sir  James  Paget,  Lancet,  1873,  ii.  513. 


126  THE  FOECE  OF  MIND 

erroneously  purposive  and  mental,  and  should  we  not 
call  it  the  unconscious  mind  ? 

Eichhorst,         Eichhorst l  says  that  '  hysteria  is  properly  attri- 
fndquet>      buted  to  disturbances  in  the  cerebral  cortex.' 
Bernheim          Briquet,2  in  the  best  work  published  on  hysteria, 
holds  that  the  seat  of  hysteria  '  is  the  brain  and  not 
the  uterus.'     Page  shows  that  the  brain  (unconscious 
mind)  is  the  cause  of  the  railway  spine,  and  that  it  is 
not  due,  as  Erichsen  and  Erb  thought,  to  inflamma- 
tion of  the  spinal  cord.     Bernheim  says : 3  '  How  can 
Anew         memory  set  up  a  disease  it  has  never  seen?     The 
th«Tunf°r      Disease  [hysteria]  must  be  hi  the  psychic  centres,  but 
conscious     unconsciously  ;  possibly  a  disease  of  sesthesodic  cells 
of  the  cerebral   hemisphere '  (a  new  name   for  the 
unconscious  mind). 

I  may  conclude  these  quotations  with  the  far-reach- 
ing views  of  Dr.  Buzzard,  who  has  done  so  much  in 
the  aetiology  of  this  disease ;  and  I  make  no  apology 
for  quoting  his  words  in  extenso. 

Dr  He  says  : 4  '  Hysteria  is  a  term  the  etymology  of 

Buzzard      which  is  misleading.     It  is  often  improperly  applied 

hyateria.      to   cases   of   simple  malingering,  and   others  which 

do  not  admit  of  ready  explanation.     Its  use  is  best 

restricted  to  a  condition  of  the  nervous  system  fairly 

defined,  but  the  intimate  pathology  of  which  is  not 

known  ;  characterised  by  the  occurrence  of  convulsive 

seizures  and  by  departures  from  normal  functions  of 

various  organs  leading  to  very  numerous  and  often 

perplexing  symptoms. 

1  Professor  Eichhorst,  Practice  of  Medicine,  1901. 

*  See  Twentieth  Century  Practice  of  Medicine,  x.  454. 

*  Professor  Bernheim,  Brain,  xvi.  190. 

*  Dr.  Buzzard,  Quairis  Dictionary  of  Medicine,  1883,  i.  678. 


THE  ETIOLOGY  OP  HYSTERIA          127 

1  These  are  apt  to  simulate  those  commonly  arising  Resemble, 
from  definite  alterations  of  structure ;  but  differ  from 
the  latter  in  the  fact  that  they  may  often,  even  when 
at  their  worst,  be  removed  instantaneously,  usually 
under  the  influence  of  strong  emotion.  It  would  seem 
that  there  is  a  disturbed  or  congenitally  defective  con- 
dition of  the  cerebral  substance,  involving  in  all  cases 
the  highest  nervous  centres,  and  in  various  examples 
extending  more  or  less  also  to  some  of  those  which 
preside  over  automatic  phenomena.  Partial  or  com- 
plete suspension  of  inhibitory  influence  would  appear 
to  be  the  most  patent  result  of  the  condition,  what- 
ever it  be ;  and  this  is  recognised  as  well  in  regard  to 
the  mental  as  to  the  more  evidently  physical  processes 
belonging  to  cerebral  function. 

'  A  laugh  which  cannot  be  checked,  but  continues  LOSS  of 
until  tears  flow  or  the  limbs  become  convulsed,  is  a 
typical  example  of  such  a  suspension  of  control,  and, 
if  studied,  throws  light  upon  the  nature  of  a  con- 
siderable portion  of  the  phenomena  of  hysteria.  The 
jerking  expirations  of  laughter  arise  from  excitation  of 
the  respiratory  centre ;  and  when  this  excitation,  un- 
controlled by  higher  centres,  acquires  an  abnormal 
strength,  it  extends  to  other  parts  of  the  medulla 
oblongata  and  spinal  cord,  and  produces  general  con- 
vulsions. It  overflows,  as  it  were,  into  other  nervous 
centres  which  in  health  would  receive  none  of  the 
exciting  impulse.  Between  the  lowest  (automatic) 
functions  of  the  cerebro-spinal  system  and  the 
highest  (psychical)  there  is  an  ever-increasing  com- 
plex system  of  excito-motor  processes,  which  may  be 
in  part,  or  wholly,  under  the  pathological  influence, 
whatever  it  be.'  (The  unconscious  mind  ?)  '  Hence 


128 


THE  FOECE  OP  MIND 


Biearre 

character 
shows  loss 
of  control. 


Hysterical 
paralysis 
and  an- 

apsthesia. 


'Hysteria' 
sometimes 
is  early 
stage  of 
dissemi- 
nated 
sclerosis. 


the  bizarre  character  of  the  hysterical  phenomena, 
and  the  circumstance  that  the  symptoms  always  in- 
clude modifications  of  those  processes  which  underlie 
the  mental  faculties.  The  suspension  of  the  power 
of  control  possessed  by  the  higher  centres  explains 
the  irregular  movements,  spasms,  and  convulsions. 
Hypersesthesia  and  pain  are  dependent,  probably,  in 
hysteria,  upon  such  a  molecular  change  being  initiated 
in  the  sensory  ganglionic  centres  as  is  ordinarily  pro- 
pagated from  the  periphery.'  (This,  due  to  the  uncon- 
scious mind,  I  have  described  a  few  pages  back.) 
'  Hysterical  paralysis,  on  the  other  hand,  signifies 
that  the  power  of  the  higher  centres  in  liberating 
movements  is  in  abeyance.  In  hysterical  anaesthesia 
it  is  probably  feeling  or  sensory  perception  and  not  the 
function  of  the  sensory  apparatus  that  is  in  abeyance, 
whilst  the  reflex  actions  which  result  from  excitation 
of  sensory  nerves  are  performed  in  an  orderly 
manner.  A  patient  may  work  a  needle  with  fingers 
which  can  be  touched  or  pricked  without  the  act 
being  felt.  Tactile  impressions  are  conveyed  to  the 
ganglionic  centre  by  the  afferent  nerves,  and  excite 
the  action  of  the  efferent  nerves  so  that  the  muscles 
are  contracted.  What  is  wanting  is  the  participation 
of  those  higher  centres  in  which  consciousness  runi 
parallel  to  this  physiological  action.'  I  have  already 
tried  to  explain  this  in  the  earlier  part  of  this  chapter. 
Dr.  Buzzard  has  further  shown  that  numbers  of 
cases  of  hysteria  have  been  in  fact  early  stages 
(unrecognised)  of  disseminated  sclerosis  ;  that  such 
cases  have  been  '  cured,'  and  afterwards  returned  with 
spinal  disease.  This  raises  the  question  of  the  con- 
nection of  functional  with  organic  disease,  which  is  of 


THE  AETIOLOGY  OF  HYSTERIA  129 

the  greatest  possible  interest  in  the  case  of  hysteria.  Functional 
It  often  happens  that  an  organic  lesion  produces  a  ^gamc 
functional  disturbance  sufficiently  great  to  constitute  disea8e- 
a  disease  in  itself ;  and  not  infrequently  this  attracts 
all  the  attention,  and  the  organic  basis  is  overlooked. 
Dr.   Eennie  points   out    that,1   '  associated  with 
organic  nerve  disease,  we  find  frequently  some  degree 
of  functional  disturbance.     For  example,  in  the  case 
of  hemiplegia  due  to  cerebral  haemorrhage  a  certain 
amount  of  damage  is  done  by  the  haemorrhage  to  the 
conducting  paths  from  cortex  to  spinal  cord,  some  nerve 
fibres  ruptured  and  permanently  damaged  ;  but  other 
parts  of  the  nervous  system  are  damaged  temporarily 
by  pressure  of  effused  blood  or  disturbed  circulation. 
As  the  pressure  is  relieved  by  absorption  of  the  clot  or  Functional 
restoration  of  imperfect  circulation  these  diffuse  sym-  s^ptoma 
ptoms  disappear ;  the  functional  element  is  removed,  Appear, 
the  organic  remains.     Or,  again,  in  cases  of  degenera- 
tive  disease   of   the   brain   or  cord,  such   as  tabes 
dorsalis,  the  symptoms  depend  upon  actual  degene- 
ration of  the  neurons.     But   besides  those  neurons 
which  are  degenerated  others  are  merely  impaired  in 
function,  and    so  certain  symptoms  appear   besides 
those  dependent  upon  complete   destruction   of  the 
neurons.     The   amount  of   anaesthesia   in  tabes,  for 
example,  is  a  varying  quantity ;   the  patient  when 
first  seen  may  present  much  more  extensive  areas  or 
degrees  of  anaesthesia  than  he  does  subsequently  after 
treatment.     Again,  the  association  of  hysteria  with  Hysteria 
organic  nerve  disease  is  well  recognised,  an  associa-  obscure* 
tion   which   frequently  obscures   the   diagnosis.     In  jj£gnogU 
of  disseminated  sclerosis  one  meets  with  inter- 

1  Dr.  G.  E.  Rennie,  British  Medical  Journal,  May  4,  1901. 


130 


THE  FOKCE  OF  MIND 


current  attacks  of  functional  or  hysterical  hemiplegia 

or  paraplegia.'     We  find  also  Dr.  Bury  pointing  out 

the  close  connection  of  functional  with  organic  disease. 

He  says  : l  '  Let  me  remind  you  of  the  investigations 

of   Buzzard,  Bastian,  and  others,  which  have  done 

so  much  to  narrow  the  boundaries  of  hysteria ;  and 

Advancing    state  my  belief  that  increasing  knowledge  of  pathology 

hmit°8logy     win  tend  to  reduce  its  limits  still  further.     Prolonged 


hysterical 


Hysteria 
may  lead 
to  struc- 
tural 
change. 


Diagnostic 
igns. 


vascular  spasm  or  some  other  lesion  must  underlie  a 
profound  anaesthesia  or  a  contraction  of  the  visual 
fields.  What  is  meant  by  calling  these  phenomena 
hysterical  ? 

'  In  some  cases  they  persist  for  years,  even 
throughout  life,  and,  when  they  disappear,  have  we 
adequate  knowledge  of  the  subsequent  nervous  history 
of  the  patient  ?  With  regard  to  motor  phenomena, 
such  an  authority  as  Charcot  has  stated  that  per- 
sistent hysterical  contractures,  after  lasting  for  many 
years,  may  be  attended  with  structural  changes  in  the 
spinal  cord ;  in  one  case  he  found  a  lateral  sclerosis 
which  apparently  he  regards  as  a  direct  outcome  of 
changes  started  by  the  hysterical  contracture.  I 
find  it  much  easier  to  believe  that  from  the  very 
first  there  were  minute  definite  changes  to  which 
any  hysterical  or  psychical  manifestations  were 
secondary.' 

Dr.  Buzzard  has  noted  as  a  diagnostic  sign  that 
in  hysterical  contraction  of  the  upper  extremity  the 
whole  arm  can  be  straightened  at  once ;  whereas,  in 
organic  disease,  the  straightening  of  one  part  flexes 
another. 


1  Dr.  Bury,  Bradshaw  Lecture,  British  Medical  Journal,  Nove 
ber  9, 1901. 


THE  ETIOLOGY  OF  HYSTEEIA          131 

In  hysterical  paralysis  the  knee  jerk  is  generally 
increased  while  the  plantar  reflex  is  abolished,  and 
Babinski's  phenomenon  (extension  of  big  toe  on  plantar 
irritation)  is  absent. 

Perhaps  with  this  I  may  close  this  long  chapter. 
I  have,  indeed,  gone  somewhat  beyond  our  thesis,  but 
the  amount  of  evidence  adduced  all  through  both  in 
the  way  of  argument  and  testimony  has,  I  trust, 
sufficiently  established  the  fact  that  '  the  chiei  factor 
in  hysteria  is  the  unconscious  mind.' 


132  THE  FORCE  OF  MIND 


CHAPTEB  VIII 

PHENOMENA  AND  ILLUSTRATIONS  OP 
HYSTERIA 

*  The  phenomena  of  hysteria  are  due  to  the  perverted 
action  of  the  unconscious  mind.' 

BEFORE  giving  a  few  illustrations  of  hysteria — few, 
because  the  disease  is  so  well  known — I  may  say  a 
word  or  two  more  on  its  origin  and  symptoms. 
Origin  of  Hysteria  often   begins  in    some   slight   but   real 

hysteria.          ,.  .  -n  i     i 

disease  in  a  person  with  an  ill-balanced  or  worn-out 
brain  — one  in  which  the  sub-conscious  mind  has  too 
much  sway,  so  that  feelings  ordinarily  unnoticed  are 
ever  present  to  the  consciousness.  As  the  French 
say,  '  On  s'ecoute  trop.'  Such  disease,  therefore,  long 
after  it  is  gone,  continues  to  set  up  a  train  of  associa- 
tions, in  spite  of  which  the  doctor,  finding  the  organic 
disease  gone,  may  declare  the  patient  well.  But  it  is 
not  so.  Let  me  repeat  an  illustration.  When  the 
who  rang  door-bell  rings  we  may  be  wrong  in  saying  there  is  some 
bSi?001  one  there ;  but  we  are  certainly  wrong  if  we  go  there, 
and,  finding  no  one,  say  it  is  nothing.  Something 
must  have  pulled  the  bell.  And  yet  it  is  this  which 
is  still  being  said  by  medical  men  through  want  of 
training  in  mental  therapeutics,  combined  with  too 
great  training  in  believing  in  only  what  they  can  see 


THE  PHENOMENA  OF  HYSTERIA        133 

or  feel  or  hear.  If  such  men  find  there  is  nothing 
wrong  with  the  knee-joint,  however  loudly  the  patient 
may  complain,  they  may  tell  him  there  is  nothing 
wrong  with  him.  Consider  the  injury  unconsciously 
inflicted  on  a  nervous  sufferer,  who,  feeling  agonising 
pain  in  the  knee,  is  first  well  pulled  about,  and  then, 
because  nothing  can  be  felt  locally,  is  calmly  told  that 
nothing  is  the  matter ;  and  is  sent  away  with  the 
diseased  ideal,  or  other  centre  in  the  brain,  uncured. 
The  general  predisposing  cause  in  hysteria  is  an  Cause— an 
irritable  and  unstable  state  of  the  nervous  system, 
often  combined  with  physical  weakness.  The  two, 
indeed,  frequently  form  a  vicious  circle,  and  it  is 
impossible  to  say  which  is  cause  and  which  effect. 
The  weak  nerve  system  leads  to  loss  of  appetite  and 
neglect  of  exercise ;  less  food  and  malnutrition  increase 
the  nervous  debility ;  this  leads  to  nervous  dyspepsia, 
this  to  greater  nervous  instability,  and  so  the  vicious 
action  and  reaction  continues.  The  chief  exciting 
mental  causes  are  religion  and  love,  worries  of  all  sorts, 
conflicts  between  evil  and  conscience,  morbid  intro- 
spection, sexual  feelings,  and  the  emotions  generally. 
The  chief  physical  exciting  cause  is  some  existing 
disease  or  accident.  It  is  restrained  emotion  that  has  no 
relief  or  reaction  in  speech,  weeping,  or  physical  action 
that  is  worst  in  its  effects.  A  man  who  gets  a  great 
shock  at  his  dinner  can  eat  no  more  without  some 
reaction  or  outlet  first.  If  he  even  speaks,  he  is 
relieved  and  may  then  be  able  to  go  on  eating. 

Hysterical   symptoms   may  arise  in  pure  ideas 
(ideogenic),  or  be  the  result  of  the  conversion  of  the  BymptoD 
pent-up  psychical  into  the  physical. 

The  tendency  in  hysteria   is  to  change  psychic 


134  THE  FORCE  OF  MIND 

irritation  into  morbid  physical  phenomena  (i.e.  bodily 
affections). 

Drs.  Breuer  and  Freud  furnish  us  with  a  striking 
instance  : ' 

The  '  A  young  lady  (21),  after  the  death  of  her  father, 

chined      nad  pains  in  walking,  with  a  hysterogenic  zone  over 
into  the       tne  mner  side  of  her  right  thigh. 

'  This  was  traced  to  two  psychic  causes— the  conflict 
against  illicit  love  for  her  sister's  husband,  and  the 
mental  strain  of  nursing  her  father.  The  inner  side 
of  the  right  thigh  was  the  centre  of  the  disturbance, 
because  it  was  on  this  she  supported  her  father  when  the 
dressings  were  changed,  and  her  feelings  were  then 
naturally  most  acute.  The  physical  pain  was  the 
counterpart  of  the  psychic.  Pain  in  walking  was  felt 
because  she  used  to  go  out  with  her  brother-in-law,  for 
whom  she  had  a  strong  affection,  which  she  could  not 
gratify.' 

Mind  often        In  hysteria  there  is  more  psychic  than  physical 

nonnaL*     change.     It  is   seldom,  indeed,  that  neuromimetics 

Pwn  does     have  quite  ordinary  conscious  minds.     It  is  of  some 

prod^cT"7  interest  to  notice   that  even  in  prolonged    neuro- 

chan^       mimesis  the  parts  affected  generally  undergo  no  organic 

change  ;  there  may  be  intense  suffering  with  little  or 

no  alteration  in  structure.2 

Hysterical         Though,  however,  the  mind  may  not  be  normal, 

whoUy*u  "   I  musti  repeat  that  true  neuromimesis  is  not  only  never 

conscious,    consciously  produced,  but  in  most  cases  there  is  no 

knowledge  that  it  is  mimicry,  the  process  being  carried 

out  from  first  to  last  by  the  unconscious  mind.    To  say, 

therefore,  that   the   'hysterical  fit   differs  from  the 

1  Dr.  Breuer  and  Dr.  Freud,  Studien  itber  Hysteria.    Wien,  1895. 
*  To  this  there  are  exceptions,  which  I  have  noted  at  the  close 
of  the  previous  chapter. 


THE  PHENOMENA  OF  HYSTEEIA        135 

nervous  mimicries  of  disease  in  being  involuntary,'  is 
to  make  a  great  mistake,  and  one  probably  due  to  the 
limitation  of  mind  to  consciousness,  of  which  we  have 
already  said  so  much. 

It   would,   indeed,    be    impossible    for    nervous  TOO  com- 

.        r  .  .,,    plicated 

mimicry  in  many  cases  to  be  voluntary;  for  no  will  to  be 
power  can  produce  such  complicated  phenomena  as  voluntary' 
the  mimicries  of  some  diseases,  which  moreover  are 
maintained  for  days  and  weeks.     Such  a  feat  is  be- 
yond the  powers  of  the  most  accomplished  actor. 

Perhaps  it  might  be  well  now  to  summarise  the  Symptom* 
symptoms  of  hysteria  in  one  list,  as  I  have  done  in  the 
case  of  neurasthenia  in  Chapter  VI.  Hysteria  (using 
the  term  broadly)  is  characterised  by  anaesthesias 
in  all  parts  of  the  body,  in  regions,  patches,  sides, 
and  limbs — by  visual  anaesthesias  resulting  in  nar- 
rowed fields  of  vision— by  fits  or  paroxysms  with  or 
without  incomplete  loss  of  consciousness  and  accom- 
panied  by  clonic  and  occasionally  tonic  spasms,  tre- 
mors, convulsive  movements,  and  large  contortions, 
sometimes  of  extreme  violence,  with  or  without  cries, 
foaming  at  the  mouth,  clenching  of  hands  and  other 
emotional  signs — by  dysaesthesias  or  pains  in  any 
joint  in  the  body,  often  in  several ;  in  zones  or 
patches,  in  the  head,  the  back,  the  heart,  the  abdomen, 
the  coccyx,  the  breast,  the  mucous  membrane,  the 
organs  of  special  sense,  the  limbs  and  the  organs  of 
generation — by  paresis  and  paralysis  of  every  or  any 
part  of  the  body  capable  normally  of  voluntary  motion 
— by  contractions  and  wasting  of  limbs  or  parts  of 
limbs — by  tremors,  continual  and  intermittent — by 
mental  states,  ecstatic,  vague,  demoniac,  talkative, 
taciturn,  &c. — by  dermatoses — by  Eaynaud's  disease 
—by  urticaria,  hyperaemias  of  skin  and  other  erup- 


136  THE  FOECE  OP  MIND 

tions — by  haemorrhages  from  organs  and  under  the 
skin  in  all  parts  of  the  body — by  stigmata— by 
muscular  atrophies  (detected  in  lower  limbs  by  absence 
of  Babinski's  sign,  extension  of  big  toe  on  tickling 
sole) — by  pyrexias  of  all  sorts — by  paraplegia — by 
are  nearly  hemiplegia — by  tetany — by  inco-ordination  of  muscu- 
tiouaLC  lar  movements — by  swellings  and  tumours  (perfectly 
simulated)  of  all  sorts,  largely  abdominal,  fluctuating, 
solid  or  pulsating  according  to  the  variety,  and  of  all 
sizes — by  abnormal  gaits  of  all  kinds — by  mutism — 
by  stammering — by  aphonia,  aphasia,  amnesia — by 
coughs  —  by  dyspnoea— by  dyspepsias  —  by  gastric 
spasms  and  gastralgia — by  flatulence— by  hsemate- 
mesis— by  anorexia — by  vomiting,  ordinary  and  faecal 
— by  borborygmi — by  swollen  joints — by  dysuria, 
polyuria,  anuria,  incontinence,  retention— by  floating 
kidneys,  also  by  more  or  less  elaborate  simulation  of 
various  diseases,  such  as  hip  disease,  asthma,  Pott's 
disease,  &c. 

Let  us  now  pass  on  to  a  few  illustrations  of  various 
exciting  causes  in  hysteria. 

We  get  many  cases  arising  from  accidents  : 
Accident  '  A  lady  saw  a  heavy  dish  fall  on  her  child's  hand, 

••eating  cutting  off  ttiree  of  tne  fingers>     gne  feit  great  pam 

in  her  hand,  and  on  examination  the  corresponding 
three  were  swollen  and  inflamed.  In  twenty-four 
hours  incisions  were  made  and  pus  evacuated.' l 

Dr.  Diaz,  in  the  '  Medical  and  Surgical  Journal,' 
had  a  lady  patient  whose  lips  and  mouth  were  sud- 
denly enormously  swollen  from  seeing  a  young  child 
pass  a  sharp  knife  between  its  lips. 

Dr.  De  Fleury l  tells  us  of  '  a  girl  who  dreams  she 

1  De  Fleury,  Medicine  and  Mind,  p.  9. 


THE  PHENOMENA  OF  HYSTERIA        137 
is  pursued  by  a  man,  and  falls  into  a  ditch  and  breaks  Hysteria 

ii  XT  •  i  i          i        •      j  3    tiom  ideas 

her  legs.  Next  morning  she  wakes  bruised,  and 
declares  her  legs  are  broken.  It  is  not  so ;  but  her 
legs  are  paralysed  (by  this  dream)  for  six  months.'  De 
Fleury  tells  us  of  another  girl  who,  dreaming  she  was 
outraged,  was  full  of  bruises  and  ecchymoses  next  day. 
He  says  dreams  can  create  physical  impressions  by 
momentary  paralysis  of  the  vasomotor  mechanism. 
Whipple l  tells  us  of  a  man  of  thirty-five  with  a  dull 
pain  above  his  ankle  for  twelve  years,  with  swelling  at 
times  and  always  worse  in  a  train.  This  was  caused 
by  seeing  a  man  crushed  to  death  in  a  train. 

A  gentleman  known  to  me,  seeing  a  friend  with 
stricture  of  the  gullet,  soon  experienced  an  increasing 
difficulty  in  swallowing,  which  ultimately  was  a  cause 
of  death. 

In  the  '  Lancet '  for  January  1880,  we  read  that 
a  gentleman  (fifty-six)  thought  he  had  swallowed  his 
false  teeth.  He  felt  them  in  the  pharynx.  There 
was  a  hard  swelling  behind  the  larynx,  and  a  surgeon 
was  telegraphed  for.  The  symptoms  were  most  dis- 
tressing and  real,  until  the  missing  teeth  were  found 
in  a  drawer. 

Whipple  tells  us  of  a  young  woman  with  a  constant 
cough,  from  the  idea  she  had  sand  in  her  windpipe. 
Once  she  had  been  nearly  drowned  in  bathing,  and 
swallowed  some  water  and  sand,  which  she  had  thought 
of  ever  since.     In  the  London  Hospital  many  cases  Hysterical 
of  hysterical  abdominal  tumours  (supposed  to  be  aortic  tumours.*1 
aneurisms)  have  been  sent  hi  for  operation,  caused  solely 
by  the  observed  pulsations  of  the  abdominal  aorta  seen 
in  thin  people,  and  BO  acting  on  their  unconscious 

1  Whipple,  Mental  Healing. 


138  THE  FOECE  OJb'  MIND 

minds   that  the   abdominal   muscles  were   actually 
contracted  on  one  side  to  simulate  a  tumour,  which 
disappeared  temporarily  under  chloroform. 
Sexual  The  sexual  element  is  a  large  factor  in  hysterical 

ifys'teria.111  phenomena,  but  it  is  observed  that  mimicries  of 
uterine  diseases  seldom  go  with  organic  uterine 
diseases  ;  because  the  former  are  common  in  virgins, 
the  latter  in  the  married. 

Sir  S.  Wilks  points  out !  that '  a  subjective  ailment 
[as  of  the  uterus]  may,  by  overlooking  the  fact  that 
the  cause  is  purely  hysterical  [i.e.  mental],  be  con- 
verted into  an  organic  one.' 

Special  The  organs  of  special  sense  are  constantly  the  seat 

h^steri^  of  neuromimesis.  A  patient  of  mine  had  diplopia, 
nystagmus,  total  loss  of  taste  and  smell,  and  almost 
complete  deafness. 

Hysterical  amblyopia  is  detected  by  a  double 
object  being  seen  by  the  blind  eye.  This,  of  course, 
seems  like  a  gross  imposture,  but  it  is  done  in  good 
faith  and  absolute  unconsciousness. 

We  get  sensory  aphasia  or  word  blunders,  in- 
tensely illustrative  of  the  action  of  the  mind  on  the 
body,  and  due  to  some  lesion  of  the  psychical  sight- 
centre  on  the  occipital  lobes. 

Motor  aphasia,  or  incapacity  of  speech,  probably 
due  to  a  lesion  in  the  psychical  speech-centre  in  the 
third  frontal  convolution  of  the  left  hemisphere.  Also 
word  deafness  from  lesion  in  the  psychic  centre  in  the 
superior  temporo-sphenoidal  lobe  of  the  auditory  nerve. 

We  get  not  only  anaesthesia,  but  perversions  of 
sensation,  so  that  the  hand  in  contact  with  a  heated 
stone  may  feel  very  cold. 

1  Sir  S.  Wilkg,  Diseases  of  the  Nervous  System,  p.  365. 


THE  PHENOMENA  OF  HYSTERIA        139 

In  the  urinary  system  we  get  simulation  of  floating  Hysteria 
kidney,  formed  by  loose  abdominal  walls  and  large  urinary* 
Btomach.  8y8tem> 

A  servant  girl  mentioned  by  Bernheim  had  hyste- 
rical retention  of  urine,  where  the  unconscious  auto- 
suggestion was  so  strong  that  no  suggestion  offered 
consciously  or  hypnotically  could  cure  it.  A  lady,  on 
the  other  hand,  suffered  from  incontinence  at  Niagara 
from  the  constant  sound  of  falling  water.  Spitzka 
gives  a  number  of  cases  suffering  from  agonising 
hydrophobia,  which  recovered  on  hearing  the  dogs  that 
had  bitten  them  were  not  mad. 

Dr.  Dale  gives  a  case  of  one  boy  bitten  by  another 
who,  seized  with  symptoms  of  hydrophobia,  died  of 
fear,  when  there  was  no  rabies  in  the  bite. 

Dr.    Ormerod   points   out '  that  '  hysterical   dis-  Hysteria 
turbances  of  digestion  may  produce  deplorable   and 
even  fatal  malnutrition.'   Deaths  from  this  cause  and 
from  hysterical  dyspnoea  are,  however,  very  rare. 

Dr.  Bigi,  of  Lombardy,  records  cases  of  gastric 
ulcer  ;  and  relates  one  in  which  a  woman  of  twenty- 
six  had  hsematemesis  after  a  severe  fright ;  she  had 
indubitably  hysterical  symptoms.  After  almost  three 
months  a  second  severe  haematemesis  occurred,  and 
from  that  date  the  other  symptoms  of  gastric  ulcer 
began  to  appear.  After  the  first  haemorrhage  the 
lacerated  mucous  membrane  probably  was  restored, 
but  not  after  the  second.  He  suggests  that  the  pro- 
cess of  formation  is  comparable  to  the  production  of  a 
neurotic  oedema,  or  even  a  bullous  urticaria  on  the 
skin.  In  hysteria  the  gastric  mucous  membrane,  like 
that  of  the  lung  or  any  other  viscus,  is  liable  to 

1  Dr.  Ormerod,  in  Clifford  Allbutt's  System  of  Medicine. 


140  THE  FORCE  OF  MIND 

Hysteria  hemorrhages  arising  from  the  direct  influence  of  the 
necrosis.  neurosis.  Our  knowledge  of  trophic  affections  of  the 
skin  enables  us  to  state  that  the  process  has  a  general 
tendency  towards  necrosis  ;  the  hysterical  process 
being  thus  actually  a  gangrenous  one.  When  it  is 
situated  on  the  gastric  mucous  membrane,  the  gastric 
juice  is  able  to  maintain,  as  a  permanent  ulcer,  the 
solution  of  continuity  produced  by  an  original  haemor- 
rhage. Gilles  de  la  Tourette  and  others  have  shown 
that  half  the  clearly  diagnosed  cases  of  gastric  ulcer 
have  an  hysterical  aetiology.  This  must  be  remembered 
if  one  wishes  to  carry  out  a  suitable  and  rational 
treatment. 

Hysteria  '  A  young  lady  gave  her  father  laudanum  in  mistake, 

and  death.    when  ^9   dje(j   s|ie  was   Btruck  down,  and   lay  ten 
months  till  death  from  general  oedema  set  in.     There 
was  a  post-mortem  examination,  and  there  was   no 
cause  of  death  but  dropsy  of  mental  origin.' l 
Hysteria  With  regard  to  hysterical  temperatures,  Drummond 

^aSe  records  108°  in  one  axilla  coincident  with  98°  in  the 
other ;  Teale,  a  case  of  hysterical  fever  with  a  tem- 
perature of  118°  (?)  This  case  is  also  quoted  by  Dr. 
Ormerod.2  In  hysterical  paralysis  Charcot  observes 
the  face  is  never  paralysed. 

Hysteria  Sir  Russell  Eeynolds  gives  us  a  case  of  paralysis 

Jafaiysis.  which  shows  how  motor  and  sensory  disturbances  may 
be  first  developed  and  then  destroyed  under  the 
influence  of  ideas. 

He  was  called  to  visit  a  young  woman  whose 
father  had  lost  money,  and  had  been  paralysed 
through  grief.  She  herself  supported  the  whole 

1  Sir  H.  Marsh,  Dublin  Quarterly  Journal,  xliv.  9. 
•  See  Clifford  Allbutt's  System  of  Medicine,  viii.  116. 


THE  PHENOMENA  OF  HYSTEEIA        141 

household  by  giving  lessons  in  various  parts  of  the 
town.  When  fatigued  by  her  long  walks  she  some- 
times thought  that  she  too  might  become  paralysed, 
and  that  then  their  situation  would  become  desperate. 
The  idea  haunted  her.  Under  its  influence  her  limba 
grew  weak,  and  she  soon  lost  her  walking  powers. 

Sir  Russell  Reynolds  visited  her,  prescribed  purely 
mental  treatment,  and  at  length  convinced  her  that 
she  was  able  to  walk,  when  she  at  once  resumed  the 
practice. 

This  young  woman's   experience  confirms   (says  Paralysis 
Gliddon)  Battey's  teaching,  that  in  the  case  of  some 
subjects  who  have  never  been  hypnotised,  paralysis 
may  be  produced  by  giving  them  the  idea  that  they 
are  going  to  be  paralysed,  and  may  be  taken  away  by 
a  contrary  suggestion.     Emotion  is  a  most  common  Hysteria 
cause  of  the  aggravation  of  paralysis  agitans,  hence  paralysis 
during  sleep  movements  are  calmed.  agitans. 

During  the  Reign  of  Terror  an  abbe  was  seized  by 
the  mob.  He  escaped,  but  he  afterwards  had  continual 
tremors  of  the  limbs. 

Hack  Tuke  gives  the  following  instance  of  insanity 
from  fright : 

'  A  healthy  boy  was  lying  in  his  cradle  when  a  cock  insanity 
perched  on  the  side ;  the  boy  was  at  first  amazed,  fright. 
but  afterwards  was  afraid,  as  the  cock  stretched  his 
neck,  put  his  head  down  and  looked  closely  at  the 
boy  ;   he  then   flapped  his  wings  and  crowed.     The 
child  gave  one  sharp  cry  of  pain  and  was  instantly 
convulsed  ;  three  or  four  fits  occurred  the  same  day, 
and  the  boy  grew  up  an  idiot.' 

Anaesthesias  and  hemiansesthesias  Binet  and  Janet  Hysteria 
connect  with  a  narrowing  of  the  field  of  conscious-  sensation. 


142  THE  FOECE  OF  MIND 

ness  in  the  brain.  These  anaesthesias  in  the  most 
capricious  patches  frequently  occur  in  people  without 
the  least  symptoms  of  '  nerves.'  For  example,  a  bucolic, 
stupid-looking  girl  of  twenty  came  into  a  London 
hospital  the  other  day  with  hysterical  hemianassthesia, 
and  soon  recovered.  We  mention  this  here  to  mark 
the  point  that  hysteria  differs  from  neurasthenia  in 
not  being  in  the  least  necessarily  connected  with 
'  nervous  '  people.  It  is  true  that  all  neurasthenics 
are  not  naturally  nervous,  but  a  much  greater  propor- 
tion are  of  this  class  than  with  hysterics. 
Nenro-  It  will  be  observed  here,  and  will  be  noticed  again 

covers         further   on,  that   the   unfortunate  word  '  Hysteria,' 


we  confessedly  use  to  include  '  Neuromimesis,' 
actually  covers  a  good  deal  more  than  the  mimicry  of 
disease.  In  a  good  many  instances  given  here,  we 
find  the  mind  producing  not  so  much  mimicries  of 
disease  and  death  as  actual  lesions  and  death  itself. 
That  is  to  say,  the  power  of  the  mind  over  the  body 
goes  far  beyond  the  mere  production  of  mimicries, 
however  perfect  these  may  be  in  their  way.  In  these 
•nd  we  admit  there  is  no  real  local  lesion,  but  only  the 

Mtiaii68  unconscious  simulation  of  it.  But  when  we  find 
lesions.  examples  of  inflamed  fingers  with  evacuation  of  pus  — 
of  bruises  and  ecchymoses,  actual  death,  haematemesis, 
and  gangrene  —  we  feel  the  word  '  neuromimesis  '  has 
become  wellnigh  as  elastic  as  *  hysteria  '  itself.  And  yet 
it  would  hardly  do  to  put  these  into  a  separate  class. 
They  are  but  extreme  and  somewhat  rare  examples  of 
the  power  of  the  mind  over  the  body  ;  and  the  generic 
term  '  hysteria  '  must  at  present  cover  them  all. 

There  can  be  no  doubt  that  as  the  Force  of  Mind  is 
increasingly  understood,  and  the  mental  factor  acknow- 


THE  PHENOMENA  OF  HYSTEEIA        143 

lodged,  our  nomenclature  will  be  revised,  and  placed  Nomen. 
upon  a  more  intelligible  footing.     To  attempt  to  do  so 


here  would  be  to  add  to  a  task  already  sufficiently  revised- 
onerous,  another  equally  great. 

I  must  be  content,  therefore,  and  more  than  Concin- 
content,  if  in  these  chapters  I  succeed  in  any  marked 
degree  in  establishing  in  my  readers'  minds  an 
appreciation  of  the  remarkable  part  the  unconscious 
mind  plays  in  the  cause  and  cure  of  diseases,  even  if 
I  have  to  leave  the  right  naming  of  many  of  these 
diseases  in  a  state  of  chaos. 

Without,  therefore,  dogmatising  on  the  word 
Hysteria,  I  trust  I  have  shown  in  this  chapter  that 
'  the  phenomena  of  hysteria  are  due  to  the  perverted 
action  of  the  unconscious  mind.' 

With  this  chapter  the  first  half  of  this  book  is 
concluded.  Our  task  has  been  to  demonstrate  the 
Force  of  Mind  and  the  mental  factor  in  medicine  in 
connection  with  aetiology  and  the  causation  of  disease. 
In  the  second  half  we  shall  be  occupied  with  the  con- 
sideration of  the  part  played  by  the  Force  of  Mind 
and  the  mental  factor  in  medicine,  in  therapeutics, 
or  the  cure  of  disease. 


PAET  II 

THE  ACTION  OF  THE  MIND  IN 
CUEING  DISEASE 


ftt 


CHAPTER   IX 
ON  PSYCEO-THEBAPT 

'  The  force  of  mind  in  therapeutics,  so  largely  ignored 
by  the  profession,  is  generally  exploited  by  quacks  for 
their  own  ends.' 

I  HAVE  now  traced  briefly  and  imperfectly  the  connec-  Reason  of 
tion  of  the  mind  with  the  body  in  health,  in  ordinary  Jnlhe  taak 
diseases,  and  in  nervous  ailments.     My  task  has  been  B0  far> 
far  from  easy,  and  has  been  handicapped  all  through 
by  having  continually,  in  describing  the  part  of  the 
mind  that  is  mainly  connected  with  physical  pheno- 
mena, to  use  an  expression,  '  the  unconscious  mind,' 
that  is  not  only  not  yet  current  in  the  best  medical 
and  psychological  circles  in  England,  but  often  meets 
with  an  animosity  that  would  be  hard  to  understand, 
were  it  not  a  well-known  fact  that  '  shibboleths '  are 
as  strenuously  insisted  on  in  science  as  in  religion. 

But  it  seems  to  me  that  the  task  so  far  has  been  Greater 

.....  ,     ,         ...          ,      ,    difficulties 

comparatively  simple,  when  contrasted  with  what  ahead, 
still  remains  to  be  done.  It  is  one  thing  to  give  a 
passive  assent  to  an  unpalatable  doctrine,  and  quite 
another  to  give  it  our  active  support.  And  yet  this 
is  the  difference  between  aetiology  and  therapeutics : 
we  observe  the  one,  but  we  practise  the  other. 


148  THE  FOECE  OF  MIND 

in  regard-    Hitherto  we  have  spoken  of  the  mental  factor  as  a 

wV^ans  cause  in  disease,  but  now  we  turn  to  it  as  a  means  of 

of  cure.       cure  .  an(j  the  discerning  reader,  who  may  himself  be  a 

very  Gallic  in  his  indifference  to  the  questions  raised, 

will  yet  readily  appreciate  the  fact  that  those  who 

disallow  its  claims  to  be  the  one  will   take  a  still 

greater  exception  to  it  as  the  other. 

s«  reasons        I  think  there  are  in  all  probability  several  reasons 
[^fg8"       why  so  many  of  us  distrust  and  dislike  the  very  idea 
of  mental  therapeutics.     May  I  suggest  half  a  dozen 
that  occur  to  me  at  the  moment  ? 

The  idea  is  distrusted  and  disliked — 

1.  Because 

so  many  please 
To  think  their  duty  is  to  core  disease ; 

•  forgetful,'  too  often, 

of  this  lesson  still, 
'Tis  not  the  body,  but  the  man  is  ilL 

A  man  whose  sole  idea  is  to  fight  disease,  thougt 
trained  in  all  the  science  of  the  schools,  is  stil/ 
oblivious  of  the  physician's  noblest  work,  and  maj 
well  '  pass  by  on  the  other  side  '  the  subject  before 
us. 

2.  Another  reason  is  the  deep  mistrust  with  which 
the  ordinary  British  mind,  even  when  fairly  educated, 
regards  the  influence  of  the  mind  over  the  body ;  in 
the  face  of  the  quackery  and  knavery  which  exploit  it 
unscrupulously  to  their  own  ends. 

8.  A  third  is  because  of  its  possible  connection  with 
hypnotism  (which  is  still  in  very  doubtful  favour  in 
the  best  medical  circles) ;  or  with  certain  well-adver- 
tised (and  lucrative)  '  systems  of  cure.' 


ON  PSYCHO-THEBAPY  149 

4.  Fourthly,  because  (limiting  the  mind  to  con- 
sciousness) they  find  by  experience  how  little  can  be 
effected  in  cure  by  conscious  efforts,  however  deter- 
mined. 

5.  Fifthly,  because  the  Zeitgeist  -the  spirit  of  the 
(medical)  age  -  is  against  it.     Scientific  diagnosis  and 
clinical  work  naturally  lead  to  scientific  cures,  and 
anything  else  is  more  or  less  suspected. 

6.  And  lastly,  because  so  many  are  ignorant  of  a 
subject  which  has  formed  no  part  of  their  medical 
curriculum  at  college  or  hospital. 

It  seems  to  me  these  six  reasons  are  amply  sufli- 
cient  to  account  for  the  way  mental  therapeutics  are 
regarded  by  the  majority  of  us  to-day. 

I  may  perhaps  be  pardoned  for  quoting  here —  A  letter 
a  propos  of  our  subject — from  a  letter  I  wrote  to  '  The  Lancet*1 
Lancet '  on  June  2,  1894,  on  this  topic.    Keferring 
to  a  previous  article,  I  said  : 

1  My  previous  remarks  in  "  The  Lancet,"  written 
with  a  view  to  call  attention  to  the  much-neglected 
subject  of  Mental  Therapeutics,  received  great  point 
from  an  annotation  in  the  same  number  on  the 
"  Immunity  of  Quackery."  The  writer,  speaking  of 
the  failure  of  a  recent  prosecution,  alludes  to  the  "  re- 
markable licence  "  that  quacks  enjoy.  He  points  out 
what  a  ridiculous  state  of  affairs  it  is  that  the  public 
persistently  continue  to  have  recourse  to  quacks  when 
they  have  the  whole  medical  profession  at  their 
service.  He  goes  on  to  say  that  the  eulogy  of 
grateful  patients,  though  given  in  good  faith,  cannot 
be  depended  upon ;  for,  he  proceeds  to  point  out, 
"  there  are  no  limits  to  the  imagination  of  the  hypo- 
chondriacal  and  hysterical  subject." 


150  THE  FORCE  OF  MIND 

Th«  public  '  Now,  in  all  this  the  writer  does  not  say  why  quacks 
|£ett  vdue  still  flourish  at  the  close  of  the  nineteenth  century ; 
to  'cores.1  nor  w}^  jn  fafa  educated  period,  they  are  as  numerous, 
or  more  so,  as  in  the  dark  ages,  and  can  still  un- 
doubtedly produce  large  numbers  of  genuine  cures. 
If  the  common  sense  of  the  public  has  not  yet  enabled 
this  enlightened  body  to  sufficiently  distinguish  be- 
tween the  value  of  the  regular  orthodox  practitioner 
and  the  opposing  army  of  quacks,  special  "  pathists," 
and  faddists  of  all  sorts,  whether  Counts  or  commoners, 
it  is  to  be  feared  that  there  is  rather  a  poor  prospect 
of  their  ever  doing  so  as  long  as  matters  are  as  they 
are.  The  public,  curiously  enough,  set  a  far  higher 
value  on  a  "  cure  "  than  the  trained  professional  man. 
With  him,  we  may,  I  think,  assert,  interest  centres  in 
the  diagnosis  of  the  disease,  and  it  is  to  this  point 
that  the  most  careful  teaching  and  training  are 
directed.  We  do  not  say  that  to  most  it  is  the 
"  end ;  "  but  it  is  certainly  a  very  prominent  "means  " 
indeed  to  it,  and  necessarily  so.  The  public,  and 
with  them  the  quacks,  care  little  about  the  diagnosis, 
for  which  they  have  neither  learning  nor  interest ; 
what  they  do  look  for  is  the  cure,  which,  alas  !  is 
often  effected  without  any  diagnosis  at  all,  though 
not  without  grave  risk  to  the  patient  for  want  of  it. 
As  long,  therefore,  as  quacks  cure  diseases,  so  long 
will  the  public  employ  them  ;  and  no  amount  of 
Carlylean  quotations  as  to  the  number  of  fools  in 
the  world,  or  contemptuous  classification  of  the 
cured  diseases  as  imaginative,  will  alter  their  atti- 
tude. 

'  What  requires  to  be  done,  and  what  must  come  to 
pass  before  long,  is  the  recognition  by  the  medical 


ON  PSYCHO-THEEAPY  151 

profession  that  the  secret  of  the  perennial  vitality  of  Vitality  oi 
quackery  is  that  it  has  used  (no  doubt  ignorantly)  dueCto6ry 
what  the  medical   profession   has   so   systematically  gaoler 
ignored  (at  any  rate  in  its  teaching)  :  the  value  and  ^y- 
the  curative  power  of  mental  therapeutics.     I  have 
looked  again  through  many  leading  books  on  medicine 
and  therapeutics,  but  neither  in  Ziemssen  nor  in  Hare 
(as  representing  the  latest  American  views),  nor  in 
any  other  standard  work,  can  I  find  this  subject  fairly 
considered  and  discussed.' 

The  fact  is,  that  much  medical  teaching  is  circum- 
scribed by  such  well-defined  boundaries — boundaries, 
by  the  way,  of  which  it  is  intensely  proud — that  no 
surprise  need  be  felt  when  we  find  any  subject  denied 
a  serious  hearing  which  lies  outside  these  limita- 
tions. 

Dr.    Clouston  says : l   '  Mental   therapeutics  are,  !>>•• 
fortunately,  had  recourse  to  far  more  now  than  of  old.  On  menui 
The  exhilarating  and  nutrition -stimulating  effects  on  ^utio*. 
health  of  pleasant  social  intercourse,  change  of  scene, 
of  beautiful  landscapes,  of  the  summer  sea  shining  in 
the  sunshine,  are  now  universally  recognised.    Bright 
and  cheerful  surroundings  in  our  hospital  wards  are  no 
unimportant  part  of  the  cure  of  their  patients.     The 
cures  effected  at  our  hydropathics  and  watering-places 
are  surely  mental  in  a  large  degree.    What  tonic  and 
promoter  of   convalescence  is  equal  to  the  "  merry 
heart  "  which  the  wise  man  says  heals  like  a  medi- 
cine ?      If    we   fully   accept    and    apply  the  sound 
principle  that  the  brain  cortex  and  mind  constitute 
the  great  central  resisting  energy  against  the  occur- 

1  Dr.  Clouston,  British  Medical  Journal,  January  18, 189ft. 


152  THE  FOBCE  OP  MIND 

rence  of  disease  and  one  of  the  great  forces  that 
make  for  its  cure,  we  thus  get  an  explanation  of 
many  facts  that  cannot  be  explained  on  any  localising 
theory.  Such  a  conception  prevents  us  from  falling 
into  that  evil  sort  of  surgical-mindedness  which  takes 
account  only  of  the  gross  anatomy  of  the  part  affected, 
and  such  things  as  can  be  seen  and  felt  by  the 
surgeon.  It  enlarges  our  conception  of  the  human 
organism  into  something  of  that  degree  of  complica- 
tion which  actually  exists  in  Nature.  It  affords  an 
explanation  of  many  of  those  miscalculations  and 
disappointments  which  we  all  only  too  frequently 
experience.  It  explains  to  some  extent  the  extra- 
ordinary differences  hi  the  action  of  the  same  remedy 
in  different  persons,  and  in  the  same  person  under 
different  conditions.  You  are  probably  aware  what 
enormous  doses  of  certain  drugs  an  acutely  maniacal 
or  an  excited  melancholic  patient  will  tolerate,  and, 
indeed,  will  require  for  us  to  get  the  effect  desired. 
Brain  The  brain  cortex,  in  a  state  of  disturbance  and  dis- 
toSb*tcan  ease,  inhibits  to  a  large  extent  the  action  of  many 
Jjjj^  drugs.  I  have  given  in  old  tunes  a  maniacal  patient 
half  an  ounce  of  tincture  of  opium  within  a  week  after 
beginning  to  use  the  drug,  and  we  frequently  use 
paraldehyde  in  half-ounce  doses  before  sleep  can  be 
obtained,  while,  in  some  cases,  several  drops  of  croton 
will  not  purge.  In  melancholia  and  some  other  forms 
of  insanity  we  find  intense  sluggishness  of  the  bowels, 
of  the  skin,  and  of  the  secretory  glands  that  result 
entirely  from  the  morbid  cortical  condition,  which  the 
usual  laxatives,  sudorifics,  and  cholagogues  will  not 
remedy.' 

And   yet,    how   foolish    any    discussion   of    the 


ON  PSYCHO-THEEAPY  153 

'  mental  factor '  must  seem  to  those  who,  rightly  K 
enough,  impressed  with  the  marvellous  mechanism 
of  the  living  body,  can  see  nothing  beyond  the 
mechanism,  and  who  therefore  believe  the  art  of  the 
medical  man  to  be  as  material  and  exact  as  that  of  a 
mechanic  in  a  factory. 

By  doctors  of  this  school  a  man  is  regarded  pretty  An  invalid 
much  as  a  superior  cycle,  or  rather  perhaps  a  motor-car, 
might  be,  and  resembles  the  latter  in  being  frequently 
subject  to  inconvenient  breakdowns.  It  is  clear  to 
these  that  the  use  of  adequate  means,  a  little  screwing 
up  here  or  there,  a  new  nut  or  bolt  or  strap,  will  effect 
the  repair  and  restore  the  machine  to  health  ;  and  not 
only  so,  but  they  can  prove  this  by  the  numerous 
machines  they  have  successfully  repaired  apparently 
by  these  methods  alone.  To  the  materialist  the 
invalid  has  for  therapeutic  purposes  no  more  mind 
than  the  car  ;  while,  even  if  the  medical  man  credits 
himself  with  any  mental  force,  he  does  not  for  a 
moment  suppose  it  can  in  any  way  assist  his  patient, 
any  more  than  it  can  matter  to  the  motor-car  who 
the  mechanic  is  that  repairs  it,  provided  the  right 
means  are  used. 

I  am  aware  the  simile  is  not  very  apt,  but  it 
may  be  effective  enough  for  my  purpose. 

Has   it,  then,  ever  occurred  to  our  materialistic  Thedoctoi 
medico  to  ask  how  it  is  that  the  human  motor-car  is 
often  perfectly  repaired  by  means  which  to  him  are  ,n 
ludicrously  inadequate— having  often  little  that  is 
material  about  them  ;  or,  on  the  other  hand,  what  is 
equally  puzzling,  how  it  comes  to  pass  that  the  same 
bolts  and  nuts  put  in  by  one  mechanic  repair  the 


154 


THE  FORCE  OF  MIND 


Many 
qnack 
cares  are 
genuine. 


Dogma- 
tism cures. 


The 

reason  of 
1  agnostic ' 
attitude  of 
doctors. 


The 

paradox  of 
quackery. 


machine,  while  exactly  the  same  process  fails  in  the 
hands  of  another  ? 

That  such  is  the  case  in  medicine,  though  not  hi 
mechanics,  is  well  known;  and  it  is,  I  think,  abundantly 
clear  that  faith  and  quack  healing  of  all  sorts  could 
never  have  attained  the  position  they  have  in  the 
leading  centres  of  civilisation  and  intelligence  were  not 
the  cures  numerous,  and  in  very  many  cases  genuine. 

The  fact  is,  the  most  materialistic  medicine  man 
going  uses  constantly  with  his  patients,  malgrS  soi, 
and  wholly  unconsciously,  the  curative  influences  of 
the  mind.  His  very  cocksureness  as  he  '  screws  up 
the  bolts,'  his  exactitude,  his  dogmatism,  and  his 
'no-nonsense'  manner,  all  profoundly  impress  the 
patient,  and  produce  a  confidence  and  a  belief  in  his. 
powers  that  cure,  quite  as  much  as  the  means  he 
uses. 

Let  us  proceed  to  review  in  a  little  more  detail 
this  remarkable  subject  of  quackery,  and  I  think  we 
shall  understand  somewhat  better  the  reason  of  the 
physician's  agnostic  attitude  towards  mental  thera- 
peutics. We  see  him  beset  on  all  sides  by  a  very 
army  of  irregulars,  who,  in  spite  of  his  edicts  and 
medical  ethics,  continue  to  defy  the  laws  of  both 
ethics  and  science  by  stealing  some  of  his  best 
patients,  and,  worse  still,  by  curing  them  with  means 
which  to  him  are  wholly  inadequate,  after  the 
manner  so  graphically  portrayed  in  the  letter  from 
Sir  James  Paget  with  which  this  book  opens. 

One  of  the  most  extraordinary  paradoxes  surely 
of  to-day  lies  in  the  fact  that,  simultaneously  with 
an  advance  in  scientific  medicine  wholly  unparalleled 
in  the  world's  history,  there  is  on  every  side  a 


ON  PSYCHO-THEEAPY  155 

quackery  that  flourishes  and  triumphs  as  much  as, 
or  more  than,  in  the  darkest  of  the  dark  ages. 

It  is  the  general  rule  that  as  the  true  light  shines 
the  darkness  disappears.  It  is  not  so  here.  Nor  can 
it  be  said  that  it  is  in  the  less  civilised  parts  of  the 
earth,  where  scientific  medicine  is  rare,  that  most 
quacks  are  found.  The  reverse,  strange  to  say, 
obtains.  It  is  in  America,  and  the  most  enlightened 
parts  of  America  ;  it  is  in  England,  and  in  the  heart 
of  its  most  intelligent  centres,  that  quackery  flourishes ; 
and  we  now  speak  of  quackery  pure  and  simple. 

Only  a  year  or  two  ago  there  was  started  most 
successfully  in  London  a  system  of  curing,  not  one 
or  two,  but  all  diseases,  by  little  bottles  of  medicine 
(so  called)  sold  across  the  counter  by  any  chemist, 
the  diagnosis  being  made  by  the  sufferer  ! 

But,   from   the   doctor's   standpoint,   worse    still 
remains.     Quackery  would  soon  come  to  an  end  and  disappear 
fade  away  before  the  spread  of  knowledge,  and  the  ' 


cures  were 


decay  of  superstition,  under  the  fostering  care  of  the  effected- 
School  Board  and  the  higher  educational  system,  but 
for  one   thing.     It   can   show  real   cures,  both   un- 
deniable and  numerous,  in  spite  of  the  vast  number 
that  may  not  bear  scrutiny. 

This  the  physician  cannot,  alas !  deny,  though  he  Quack 
may  deplore  it.  After  allowing  full  discount  for 
forged  and  false  testimonials  (which  are  not  so 
numerous  as  supposed),  for  purely  imaginary  diseases 
and  the  credulity  of  mankind,  and  even  for  the  lesser 
functional  disorders,  there  remains  behind  a  large 
residuum  that  cannot  by  any  ingenuity  be  explained 
away.  At  any  rate,  the  public  believes  it  has  suffered 
from  some  disease,  say,  rheumatism,  for  which,  in 


156  THE  FOECB  OF  MIND 

the  ordinary  course  and  the  absence  of  the  quack,  it 
would  have  gone  to  the  nearest  doctor ;  with  the  result 
of  a  possible  more  or  less  tardy  cure,  and  the  certainty 
of  a  considerable  bill.  Whereas  now,  the  purchase 
for  l\d.  or  Is.  l±d.  of  a  small  bottle  of  something  in 
a  wrapper  black  with  testimonials  has  already  given 
relief,  maybe  even  before  it  has  been  taken,  on  the  mere 
reading  of  the  wonderful  cures  effected.  The  ignorant 
charlatan  may  thus  effect  with  his  shallow  mysteries 
what  a  great  physician  cannot  do  with  his  science, 
because  wonder  and  awe  have  a  greater  therapeutic 
power  than  respect.  In  this  case,  of  course,  the 
remedies  used  on  both  sides  are  regarded  as  inert ; 
and  yet  we  believe  it  is  true  that  many  of  our  most 
useful  medicines  have  been  discovered  by  quacks. 

Now  it  is  quite  possible  that  no  one  is  more  sur- 
prised as  well  as  pleased  at  the  cures  than  the  quack 
vendor  of  the  same ;  and  it  is  not  for  him  to  deny 
what  he  cannot  account  for,  as  the  doctor  is  often 
tempted  to  do,  because  his  interest  is  to  magnify 
cures,  which  he  promptly  does. 

It  is  therefore  doubtless  true  that,  in  spite  of  all 
our  science,  quackery  flourishes;  and  the  reason  of 
it  is  by  no  means  that  all  men  are  fools,  but  that 
it  undoubtedly  effects  numerous  cures,  and  some — if 
it  be  not  heresy  to  breathe  it— that  have  been 
attempted  in  vain  by  eminent  scientific  men,  the 
sufferers  having  only  tried  quackery  when  all  else  has 
failed.  It  is  also  true  that  these  cures  astonish  per- 
haps equally  the  quack  and  the  doctor. 

But  let  us  go  a  little  further  and  glance  at  the 
pseudo-religious  quacks  and  humbugs  who  make  a  gain 
of  the  credulity  and  folly  of  mankind  without  recourse 


ON  PSYCHO-THERAPY  157 

to  patent  pills  or  Is.  l^d.  medicines.  These  are 
found  everywhere,  but  abound  most,  like  the  ordinary 
quack,  not,  as  might  be  supposed,  in  Eussia,  or  in 
Turkey,  or  Poland,  or  South  America,  or  other 
shady  corners  of  the  civilised  world,  but  in  the  very 
focus  of  intellectual  and  rational  life — the  United 
States  of  America. 

The  greatest  of  these  latter-day  mystics  is  un- 
doubtedly at  present  the  '  Eev.'  Mary  Baker  Eddy, 
whose  ponderous  work  on  Christian  Science,  in  two 
volumes,  is  the  text- book  of  the  entire  sect,  number- 
ing nearly  a  million  or  more  here  and  in  America  and 
elsewhere,  of  educated  followers  far  above  the  average 
in  wealth  and  culture — many,  alas  !  formerly  having 
been  among  the  most  lucrative  of  the  physician's 
patients.  This  book  is  appointed  to  be  read  by 
Mrs.  Eddy  in  all  her  churches,  side  by  side  with  the 
Bible  ;  and  in  one  of  her  handsome  buildings  in  New 
York,  that  cost  over  20,OOOZ.,  as  well  as  in  their  first 
English  church,  not  very  far  from  Harley  Street,  this 
work,  '  Science  and  Health,'  is  read  every  Sunday  to 
a  crowded  and  attentive  congregation  of  upper-class 
educated  people.  With  their  dogmas  one  need  not 
interfere  ;  cures  are  detailed  and  vouched  for  by  the 
healed  at  every  meeting,  and  though  to  some  judg- 
ments Christian  Science  contains  neither  Christianity 
nor  science,  as  generally  understood,  these  cures  can- 
not all  be  doubted  or  explained  away.  (I  may  return 
more  fully  to  this  subject  in  a  future  chapter.) 

Of  the  lower  class  of  pseudo  faith-healers,  we  hear 
of  one  in  New  Jersey,  with  15,000  more  or  less  edu- 
cated patients  in  one  week.  Chicago  has  been 
turned  upside  down  with  one,  amongst  others,  who 


158  THE  FORCE  OF  MIND 

has  the  walls  of  the  largest  hall  in  the  city  covered 
with  crutches,  splints  &c.  presented  by  cured  fol- 
lowers ;  and  indeed  all  over  the  States  the  name  of 
these  religious  quacks  and  humbugs  is  legion,  and 
their  harvest  plenteous  and  golden.  Now,  though 
populus  vult  decipi  is  undoubtedly  true,  and  though 
most  men  are  fools,  still  cures  are  effected  not  only  by 
respectable  quacks,  but  by  the  most  arrant  knaves, 
and  testified  to  by  most  reputable  persons,  and, 
curiously  enough,  largely  by  the  clergy.  Many 
indeed  are  not  lasting  ;  many  are  very  trivial,  and 
many  may  be  said  to  be  due  to  hypnotic  influence  of 
one  sort  or  another. 

But,  again,  what  about  hypnotism  and  Nancy  and 
the  Salpetriere  ?  The  investigations  of  the  '  British 
Medical  Journal '  have  shown  that  here  we  have  to 
deal  with  a  quite  inestimable  amount  of  fraud  and 
self-deception  ;  but  observe,  we  have  now  to  examine 
the  work  of  learned  professors,  regular  and  registered 
physicians,  and  not  that  of  mere  charlatans.  We  have, 
or  had,  Charcot  in  France,  and  names  of  honour  and 
repute  in  this  country  who  testify  to  cures  of  all  sorts 
without  medicine  or  physical  means,  but  in  this  case 
purely  (if  the  word  may  be  coined)  by  '  psychism  '  in 
the  form  of  suggestions — suggestions,  too,  which 
appear  powerless  when  presented  directly  to  con- 
sciousness, and  only  highly  efficacious  when  the 
patient  is  in  the  '  hypnotic  '  state.  All  these  things 
are  a  riddle  and  most  perplexing,  and  when  the  last 
echo  of  the  laughter  of  derision  and  the  last  curve  of 
the  smile  of  contempt  have  died  away,  there  remains 
much  to  make  the  physician  of  the  period  at  least 
thoughtful. 


ON  PSYCHO-THEEAPY  159 

Again,    what    about    homoeopathy,    hydropathy,  Homoeo- 
Matteism,  and  all  the  many  and  flourishing  Swedish,  SUSS^ 
German,  Austrian,  Italian,  and  other  special  cures  ? 
Are  they  all  unworthy  of  the  name  ?     By  no  means. 
Here  a  semi-  or  pseudo-scientific  basis  is  more  or  less 
attempted,  many  excellent  hygienic  formulae  are  ob- 
served, which   elevate  these  above  the  mere  rank 
quackery  we  have  spoken  of.     But  the  great  point  is 
that  cures,  and  remarkable  cures  too,  are  everywhere 
effected.     And  here,  indeed,  may  be  added  that  it  is  J^** •*• 

.,  ,      .  '    ,.  J.      ,    .  functional 

impossible  to  say  all  these  are  what  in  our  ignorance  aiseaaea? 
at  present  we  crudely  class  as  'functional,'  though, 
doubtless,  most  are.  Is  rheumatism  a  functional  or 
an  organic  disease  ?  Is  dropsy,  is  erythema,  is 
eczema,  is  paralysis?  Some  hyperscientist  may 
object  that  some  of  these  are  symptoms  and  not 
diseases.  But  what  is  a  symptom  and  what  is  not 
a  symptom  ?  Nay,  more,  what  is  a  disease  ?  And 
until  we  can  answer  this  last  profound  question,  how 
do  we  know  whether  it  is  functional  or  organic  or 
both  ?  Our  own  broad  definition  of  the  two  would  be 
that  '  functional '  disease  is  that  which  is  of  psychic 
origin  ;  '  organic,'  that  which  is  of  physical.  At  the 
bottom  all  diseases  involve  some  organic  change  some- 
where. 

But  this  is  not  all,  in  the  way  of  inexplicable 
cures. 

What  about  Lourdes  ?  Or  if  that  be  a  centre  of 
imposture,  which  it  is,  and  yet  isn't,  what  about  our 
own  faith-healing  centres  and  others  abroad,  uncon- 
taminated  by  the  least  sympathy  with  Roman  Catho- 
licism or  saint-worship  ? 

As  these  may  not  be  so  well  known  even  to  the 

M 


160  THE  FOECE  OF  MIND 

widely  informed  physician,  a  detail  or  two  may  be 
given  showing  they  at  any  rate  exist. 

A  few  years  ago,  in  the  Agricultural  Hall,  a  great 
conference  of  some  2,000  faith -healers  was  held,  there 
being  then  some  120  faith-healing  centres  in  this 
kingdom  alone,  now  probably  many  more.  In 
America  there  are  over  thirty  homes  (one  of  which 
cost  over  6,OOOZ.  presented  by  a  '  cured  '  patient)  and 
innumerable  centres.  There  are  several  in  Australia 
and  many  all  over  Europe.  A  few  years  ago  in  New 
York  and  Boston  there  was  hardly  a  believer  in  faith- 
healing,  now  there  are  thousands.  Observe  these 
have  nothing  to  do  with  the  Christian  scientists  on  the 
one  hand  or  the  pseudo-fraudulent  faith-healers  on 
the  other,  of  whom  I  have  spoken.  These  are 
orthodox,  severely  Protestant,  and  mostly  evangelical. 

In  one  long  list  of  250  published  cases  of  disease 
cured  we  find  five  '  consumption,'  one  '  diseased  hip,' 
five  '  abscess,'  three  '  dyspepsia,'  four  '  internal  com- 
plaint,' two  'throat  ulcer,'  seven  'nervous  debility,' 
nine  'rheumatism,'  five  'diseased  heart,'  two  '  withered 
arm,'  four  '  bronchitis,'  three  '  cancer,'  two  '  paralysed 
arm,'  three  'weak  eyes,'  one  'ruptured  spine'  (?), 
five  '  pains  in  the  head.'  And  these  are  the  results 
in  one  year  at  one  small  chapel  in  the  north  of 
London !  The  list  causes  amusement  and  perhaps 
surprise ;  and  impatience  may  be  felt  that  such  puerile 
details  should  be  given.  Pace  my  scientific  and 
learned  friend,  to  the  poor  sufferers  it  was  anything 
but  puerile  to  be  cured,  or  at  any  rate  relieved,  from 
diseases  from  which  they  suffered,  or  at  any  rate 
imagined  they  suffered,  free  of  all  charge ;  for  none  of 


ON  PSYCHO-THERAPY  161  ' 

these  are  money-making  agencies,  whatever  else  they 
may  be. 

What  about  charm  cures?     Perhaps  scientists  Charms, 
innocently  suppose  these  have  died  out.     Not  at  all ;  1^™'  *nd 
and  later  on  I  will  give  instances.     Suffice  it  here 
to  say  that  not  only  in  the  country  districts,  but  it 
may  be  in  the  humbler  regions  of  the  physician's 
own  house,  they  are  implicitly  believed  in,  and  more- 
over even  here  also  are  cures  effected. 

What  about  cures  by  relics  and  even  by  idols  ?  I 
am  told  that  undoubted  cures  are  effected  not  only 
by  the  Holy  Coat  of  Treves,  but  all  over  the  world, 
notably  in  India,  China,  and  Africa,  in  the  presence 
of  actual  idols.  One  in  India  is  most  famous  for  its 
therapeutic  power ;  while  large  temples  in  China  are 
covered  with  votive  offerings  from  the  '  faith-healed.' 
Trees,  plants,  flowers,  bits  of  animals,  &c.  have  all 
their  therapeutic  powers. 

But  the  patience  of  our  cultured  reader  must  not 
be  too  severely  tried.  Turn,  then,  with  relief  to  some- 
thing more  respectable. 

What  about  the  '  cures  '  at  home  and  Continental  Jj^"1* 
spas,  with  their  eternal  round  of  sulphur  and  iron  'cure*.' 
waters  and  baths  ? 

Does  the  doctor  attached  to  the  spa,  in  his  heart 
of  hearts  believe  that  all  the  cures  which  in  these 
cases  he  cheerfully  certifies  to  are  effected  by  the 
waters,  or  even  the  waters  and  the  diet,  or  even  the 
waters  and  the  diet  and  the  air  ;  or  does  he  not  think 
there  must  be  a  '  something  else  '  as  well  ?  And  to 
come  nearer  home  and  into  the  centre  of  all  things, 
and  the  chamber  of  all  his  secrets:  In  his  own 
consulting-room  and  in  his  own  practice,  is  not  the 

M  2 


162  THE  FOECE  OP  MIND 

physician  brought  face  to  face  with  cures,  aye  and 
diseases  too,  the  cause  of  which  he  cannot  account  for  ; 
and  is  he  not  often  surprised  to  find  a  continuation  of 
the  same  treatment  originated  by  the  local  practitioner 
is,  when  continued  by  his  august  self,  efficacious  ?  And 
is  not  the  local  practitioner  not  only  surprised  but 
disgusted  as  well  to  find  such  is  the  case  ? 
Orthodox          But  we  have  asked  hard  questions  enough.    We 
cures.         w'n  agk  an  eagy  one>    "What  is  the  one  effectual  agency 
in  quack  cures,  in  semi-scientific  cures  of  all  sorts,  in 
faith  cures,  in  relic,  charm,  and  idol  cures,  in  many 
spa  and  water  cures,  in  some  doctor's  cures,  perhaps 
tiJe  age^t    ***  more  tnan  n6  8U8Pec^s  ?     After  allowing  fully  for 
in  all  is       the  intrinsic  value  of  the  quack  remedy,  of  the  mystic 
Sniidoos     formulae,  of  the  millionth  dilution,  or  of  the  prismatic 
electricity ;  for  the  sulphate  of  soda  or  magnesium  and 
even  for  the  value  of  real  B.P.  drugs,  we  must  answer 
— It  is  mainly  and  primarily  the  power  of  the  uncon- 
scious mind  over  the  body.     It  is  this,  and  this  pre- 
eminently ;  and  it  is  this,  and  this  pre-eminently,  that 
is  everywhere  ignored,   however  much  other  minor 
factors  may  be  extolled. 

Now  we  see,  as  I  said  we  should,  how  hard  it  is 
for  a  physician  to  own  this,  and  here  is  the  '  other 
reason '  for  his  otherwise  inexplicable  '  agnostic ' 
position.  It  at  once  seems  to  give  a  sort  of  locus 
standi  to  the  unregistered  and  unqualified  therapeu- 
tists of  all  denominations ;  not  only  admitting  their 
cures,  but  giving  a  scientific  reason  for  them,  pro- 
bably unknown  to  themselves.  And  worse  still,  it 
puts  the  physician  at  first  sight  on  somewhat  of  the 
same  level  in  effecting  many  cures,  in  equal  ignorance, 
by  the  same  means. 


ON  PSYCHO-THERAPY  163 

Further  and  worthier  thoughts  will  reveal  that  it  is  i»  thig 
vain  to  fight  against  truth  for  any  secondary  reasons ;  true? 
and  the  question  is — Is  it  true  ? 

We  think  that  those  who  really  honour  this 
subject  with  their  grave  and  careful  consideration 
will  say  that  it  is  :  and  that  even  those  who  do 
not,  and  who  merely  skim  the  evidence  we  shall 
give,  will  say  at  least—1  There  must  be  some  truth 
in  it.' 

If  this  be  the  case,  how  strange  that  such  a  thera- 
peutic agent  should  have  been  so  ignored,  that  from 
so  few  of  our  leading  surgeons  and  physicians  do  we 
hear  the  influence  of  the  human  mind,  whose  powers 
pretty  well  balance  the  whole  Pharmacopoeia,  spoken 
of !  In  the  '  British  Medical  Journal '  we  find 
this  remarkable  sentence  : }  '  Disease  of  the  body  is 
so  much  influenced  by  the  mind  that  in  each  case  we 
have  to  understand  the  patient  quite  as  much  as  the 
malady.  This  is  not  learnt  at  hospitals.'  Or,  in 
other  words,  one-half  at  least  of  the  science  of  thera- 
peutics is  not  '  learnt  at  hospitals,'  for  the  simple 
reason — it  is  not  taught. 

Does  any  practical  medical  man,  after  all,  really 
doubt  these  mental  powers  ?  Is  he  not  aware  of  the 
ingredient '  faith,'  which,  if  added  to  his  prescriptions, 
makes  them  often  all-powerful  for  good?  Does  he 
not  know  experimentally  the  value  of  strongly  assert- 
ing that  the  medicine  will  produce  such  and  such 
effects  as  a  powerful  means  of  securing  them  ? 

If,  then,  this  power  is  so  well  known,  why  in  the  uui.^ 
name  of  common  sense  should  it  be  pooh-poohed  and  J^" 
ignored  as  it  is  ?    It  has  its  laws  of  action,  its  limita-  p°°h< 

1  British  Medical  Journal,  Eduo.  Number,  autumn  1891. 


164  THE  FOBCB  OF  MIND 

tions,  its  powers  for  good  and  for  evil ;  would  it  not 
clearly  help  the  medical  student  if  these  were  indicated 
to  him  by  his  lawful  teachers,  instead  of  his  gleaning 
them  uncertainly  from  the  undoubted  successes  of  the 
large  army  of  irregulars  ? 

A  silent  We  are,  however,  inclined  to  think  that,  after  all, 

uidngtion  *  silent  revolution  is  slowly  taking  place  in  the  minds 
place.  Of  medical  men,  and  that  our  present  text-books  on 
disease,  content  with  merely  prescribing  endless  selec- 
tions and  combinations  of  nauseous  drugs,  and  dis- 
missing any  mental  cure  in  a  single  line  as  unworthy 
of  serious  consideration,  will  in  time  be  replaced  by 
others  containing  views  more  worthy  of  the  century 
in  which  we  live. 

Drugi  are          For,  although  these  drugs  are  still  administered, 

but  few  medical  men  now  believe  that  they  are  the 

entire  cause  of  the  cure;  for  very  gradually  it  is 

beginning  to  dawn  upon  us  that  most  nervous  diseases 

at  any  rate  are  easily  and  naturally  treated  by  mental 

therapeutics,  and  that  the  still  persistent  efforts  to  cure 

them  by  the  stomach  are  neither  reliable  nor  rational. 

Mind  core         It  ill  becomes,  therefore,  the  medical  man,  who 

Edited  to    recognises  in  these  cases  that  it  is  the  mind  that  cures, 

cu^e^1  to  decry  any  form  of  faitl1  cure'  nowever  little  its 
process  may  be  understood  by  him  in  detail.  We 
have  seen  that  the  powers  of  the  conscious  mind 
over  the  body  are  wellnigh  immeasurable ;  and 
knowing,  as  we  now  do,  that  our  old  division  into 
functional  and  organic  diseases  is  merely  the  expres- 
sion of  our  ignorance,  and  that  all  diseases,  even 
hysterical,  involve  organic  disturbance  somewhere,  we 
are  prepared  to  believe  that  faith  and  other  unorthodox 
cures,  putting  into  operation  such  a  powerful  agent  as 


ON  PSYCHO-THEEAPY  165 

the  unconscious  mind,  or,  if  you  prefer  the  formula, 
'  the  forces  of  nature,'  are  not  necessarily  limited  to 
so-called  functional  diseases  at  all. 

Dr.  Clouston  makes  some  important  remarks  upon  Dr. 
the  necessity  of  understanding  the  mental  element  in 
disease,  that  we  may  quote  here.     He  says  : ! 

'  The  nervous  and  mental  element  in  disease  is  a 
universal  and  constant  fact,  but  it  prevails  in  different 
cases  to  a  different  extent.  I  could  have  related 
remarkable  cases  to  you  from  my  own  experience,  and 
out  of  the  books,  of  functional  disease  being  brought 
on  and  being  cured  by  mental  impressions  only,  of 
functions  being  suspended  and  altered  from  the  same 
cause — nay,  of  actual  organic  lesions  being  directly 
caused  and  cured  by  mental  impressions;  as  when 
blisters  are  caused  by  suggestion  during  hypnotic 
conditions.  Constipation  has  been  cured  by  doses  of 
medicine  containing  no  laxative,  but  with  dogmatic 
assurances  that  a  stool  will  follow  in  an  hour.  Warts 
have  been  "  charmed  "  away ;  scurvy  among  sailors 
has  been  cured  by  the  prospect  of  a  naval  fight ;  gouty 
swellings  have  disappeared  when  "Mad  dog"  or 
"  Fire  "  was  cried  out  suddenly  to  the  sufferers.  All 
these  things  have  happened,  but  they  occur  only 
rarely,  while  some  influence  or  other  for  good  or  evil 
is  taking  place,  in  some  degree  or  way,  from  the 
patient's  brain  cortex  and  mind  in  every  case  of  ordi- 
nary disease  that  you  will  have  to  treat.  This  is  a 
fact  that  I  am  far  more  anxious  to  impress  on  you 
than  to  relate  the  marvels  and  the  miracles  of 
medicine.  To  keep  in  mind  the  ordinary  laws  of 
Nature  as  they  ordinarily  manifest  themselves  in  life 

1  Dr.  Clouston,  British  Medical  Journal,  January  18,  1896. 


166  THE  FOECB  OF  MIND 

and  disease  in  their  sure  but  commonly  unconscious 
and  quiet  manner  of  acting,  is  of  far  more  import- 
ance to  each  of  us  than  to  know  the  wonders  and 
cataclysms  that  only  occur  once  in  a  lifetime.  The 
brain  habit  should  be  early  formed  in  a  physician  to 
take  account  of,  and  instinctively  and  without  con- 
scious effort  to  apply  the  principle  that  the  condition 
of  the  patient's  brain  cortex  and  mind  can  never  be 
an  equation  to  be  left  out  of  account  in  his  treatment.' 
Menui  ^  *8  no  doubt,  a8  I  have  sa^»  *ke  connection 

ther*-         of  mental  therapeutics  directly  with   faith-healing, 
Sits        Christian  Science-healing,  and   hypnotism;  and  in- 
™™*°~       directly  with  liquid  electricities,  billionth   dilutions, 
and  quack  remedies  of  all  sorts,  that  has  so  far  deterred 
the  profession  from  examining  very  closely  its  won- 
derful powers. 

I  feel  quite  sure,  however,  that  all  such  reasons 
will  fall  to  the  ground  when  the  fact  of  the  uncon- 
scious mind  is  admitted,  clearly  and  definitely,  by 
scientific  men  ;  and  once  its  powers  become  generally 
recognised  they  will  at  last,  after  long  neglect,  be 
made  the  subject  of  serious  study. 

It  is  somewhat  curious  that  while  the  power  of  the 
mind  over  the  body  is  so  little  thought  of,  far  too 
much  is  being  made  of  the  power  of  the  body  over  the 
mind. 

Depend-  Indeed,  it  is  time  that  a  reaction  took  place  against 

S°on      the  popular  doctrine  of  the  dependence  of  mind  on 

b^y.         body,  which  is  fast  reaching  a  reductio  ad  absurdum, 

in  the  tracing  of  every  changing  mental  state,  and 

even  of  every  morbid  impulse  or  criminal  action,  to  a 

deranged  liver  or  an  anaemic  brain.     No  doubt  before 

long  the  pendulum  in  England  will  swing  over  com- 


ON  PSYCHO-THEEAPY  167 

pletely  to  the  other  side  (as  it  has  already  done  in 
America  to  the  remarkable  extent  displayed  in  the 
1  mental  cures '  we  have  already  spoken  of),  and 
most  bodily  disorders  will  be  attributed  to  a  diseased 
mind.  The  truth  meanwhile  occupies,  as  ever,  the 
medium  position  between  the  two,  there  being  times 
when  the  body  sways  the  mind,  and  other  times 
when  the  mind  sways  the  body,  the  two  being,  as  has 
been  forcibly  expressed  by  Miss  Cobbe,  something 
like  a  pair  of  coupled  dogs  ;  sometimes  one  and  some- 
times the  other  obtaining  the  victory,  and  sometimes 
both  pulling  together  in  harmony. 

This  harmony  is  health  and  ease,  the  discord  is 
ill -health  and  dis-ease,  and  true  therapeutics  must  ever  discord  u' 
consist,  in  virtue  of  a  law  higher  than  any  framed  in 
our  colleges  or  hospitals,  in  replacing  the  one  by  the 
other. 


168  THE  FOBCE  OF  MIND 


CHAPTER  X 

THE   VIS  MEDICATRIX  NATURE 

•The  testimony  of  the  profession  as  to  the  presence 
and  importance  of  the  ••  vis  medicatrix  naturae,"  and  the 
power  of  mind  over  disease.' 

What  is      AFTBB  going  so  very  fully  into  every  possible  plea 

^Umedl     that  could  be  adduced  for  the  disregard  of  the  mental 

natura       factor  in  therapeutics,  and  showing  in  some  degree 

how  it  was  exploited  by  quacks  and  others  outside  the 

profession,  it  is  high  time  that  I  adduced  some  proof 

of  its  real  value  in  legitimate  medicine. 

The  first  point  perhaps  to  consider,  and  one  of 
great  interest,  is  what  is  meant  by  the  well-known 
expression,  vis  medicatrix  naturcB,  which  heads  this 
chapter. 

i«  it  a  It  has  of  course  been  hotly  disputed  whether  such 

a  force  exists  at  all.  Then,  if  this  be  admitted,  it  has 
been  strongly  argued  that  it  is  not  a  true  force  ;  while, 
on  the  other  hand,  by  a  very  large  majority  it  has  been 
decided  that  it  is,  and  one  moreover  of  almost  inestim- 
able value  in  cure.  It  appears  to  me  that  this '  vis '  con- 
sists of  the  natural  power  resident  in  the  unconscious 
mind  to  preserve  the  body  against  its  enemies  of  all 
Borts  ;  and,  if  these  should  have  gained  an  entrance 
in  the  shape  of  disease  or  accident,  to  combat  them 


THE  VIS  MEDICATEIX  NATUE^l        169 

vigorously;  largely  by  what  we  call  'symptoms  of 
disease '  and  also  by  other  processes.  These  '  natural 
powers,'  however,  form,  after  all,  only  a  part  of  the 
mental  factor  in  therapeutic  medicine.  Further 
powers  can  be  aroused  and  brought  into  action  by 
mental  therapy,  in  stimulating  the  patient's  own 
mind  to  greater  efforts  in  various  ways  which  we  shall 
consider.  So  that  the  vis  medicatrix  natures  and 
the  energy  aroused  by  mental  therapeutics  represent 
together  the  powers  of  the  unconscious  mind  in  its 
beneficial  rule  over  the  body.  We  will  adduce  further 
reasons  for  this  view  as  we  go  along.  First,  then,  for 
the  denial  of  the  existence  of  the  vis. 

Dr.  Pye  Smith,  in  an  inaugural  address  to  medical 
students,  says  :  '  The  vis  medicatrix  naturee  is  a  denied 
figment  which  owes  its  prevalence  to  its  Latin  dress.' 1 
This  is  not  so ;  its  vitality  is  due  to  the  truth  that 
underlies  the  dress,  which  alone  can  keep  it  alive  and 
vigorous  to-day. 

Sir  Benjamin  Ward  Kichardson  opposes  it  deter- 
minately.  '  In  the  long  catalogue  of  serious  diseases, 
Nature's  cure  is  the  last  remedy  discernible.' *  '  The 
term  vis  medicatrix  natures  is  an  entire  misnomer, 
except  it  be  limited  to  the  simple  capacity  of  the 
organism  to  resist  gravitation.  A  belief  in  it  in  the 
concrete  has  no  basis  whatever.' 3  '  If  it  be  true,'  he 
Bays  further,  '  then  physicians  are  of  no  use  save  to 
cure  their  own  maladies  by  its  power.'  (!) 

But  there  are  not  many  who  attempt  such  a  hope- 
less reductio  ad  absurdum  as  this,  which  has  only  to 

1  Dr.  Pye  Smith,  British  Medical  Journal,  October  9,  1897. 
*  Sir  B.  W.  Richardson,  Asclepiad,  1886,  p.  267. 
1  Ibid.  p.  284. 


170  THE  FORCE  OF  MIND 

be  read  to  be  self -condemned.  We  meet  with  a  more 
scientific  view  of  this  power  in  the  following,  from 
Dr.  A.  H.  Carter  (in  the  'British  Medical  Journal '), 
which,  it  will  be  observed,  while  treating  it  as  the 
passive  outcome  of  the  law  of  equilibrium,  does  not 
close  till  it  is  acknowledged  as  an  active  force  for  the 
preservation  of  the  body  : 

The  law  of  '  The  quality  of  resistance  to  which  I  have  just 
e^uiiibra  alluded  bears  such  important  relations  to  the  principles 
of  causation  and  treatment  of  disease  that  it  deserves 
to  be  examined  at  close  quarters,  in  order  to  see  what 
it  really  means  and  what  it  teaches  us.  That  the  body 
possesses  some  power  of  resisting  and  recovering  from 
the  disturbing  forces  of  disease  has  long  been  recog- 
nised, and  represents  what  is  often  described  as  the 
vis  medicatrix  natura.  But  with  regard  to  its  real 
nature  and  operation  there  has  been  much  difference 
of  opinion,  and  it  is  only  within  recent  times  that  it 
has  been  possible  to  put  the  matter  upon  a  rational 
basis.  It  certainly  represents  no  independent  force 
of  any  kind  ;  but,  as  Mr.  Herbert  Spencer  tells  us,  it 
is  the  working  out  in  the  body  of  a  law  which  obtains 
throughout  all  Nature — the  law  of  equilibration  or 
balance  of  forces.  The  living  body  is  a  moving 
equilibrium  of  a  variety  of  antagonistic  forces,  which 
on  the  one  side  is  constantly  dissipating  its  energy  in 
the  functional  activities  of  its  individual  parts,  and 
on  the  other  side  is  being  as  constantly  reinforced  by 
taking  in  fresh  motive  power.  It  is  an  equilibrium 
which,  moving  onwards  in  a  rhythmical  progress, 
preserves  a  constant  mean,  and  tends  to  re-establish 
that  mean  whenever  accidental  causes  have  disturbed 
it.  The  mean  balance  of  forces  in  movement  which 


THE  VIS  MEDICATBIX  NATUB^J          171 

characterises  what  we  call  healthy  life,  unstable  as  it 
is,  yet  as  the  result  of  adaptations  extending  indefinitely 
back  into  the  past  has  become  sufficiently  stable  to 
offer  very  considerable  resistance  to  disturbance ;  and 
if  disturbed,  short  of  being  altogether  upset,  it  tends 
to  become  re-established  sooner  or  later.  The  limit  of 
recovery  from  such  disturbance,  or  what  may  conveni- 
ently be  termed  the  index  of  resistance,  varies  somewhat 
for  each  individual.  When  the  index  is  high  we  speak 
of  such  a  man  as  strong  or  robust ;  when,  on  the  other 
hand,  it  is  low,  as  weak  or  delicate. 

1  The  special  susceptibilities  to  disease  connected  ^e  indei 

of  resist- 

with  age,  sex,  pregnancy,  lactation,  climacteric  period,  am*, 
and  the  like,  correspond  to  physiological  fluctuations 
of  the  resistance  index ;  and  these  again  merge  by 
imperceptible  degrees  into  what  are  called  "  acquired 
susceptibilities,"  which  represent  pathological  forms  of 
diminished  resistance  due  to  such  factors  as  inanition, 
fatigue,  exposure  to  cold,  and  previous  disease.  If  I 
am  not  much  mistaken,  something  of  what  passes  in 
our  medical  vernacular  as  acquired  susceptibilities  is 
not  to  be  distinguished  from  disease.  If,  for  instance, 
a  healthy  man  attacked  by  influenza  tells  us  he  has 
"never  been  the  same  since,"  it  is  probable  that  in  a 
strict  sense  he  is  still  the  subject  of  some  morbid 
process  left  over  from  the  original  disease.  At  the 
same  time,  there  are  many  cases  in  which,  after  serious 
disturbance  never  completely  recovered  from,  a  fresh 
balance  is  established  by  virtue  of  the  law  of  equilibra- 
tion, though  upon  a  permanently  lower  plane  than 
before,  and  which  henceforth  becomes  for  that  person 
a  normal  state.  Though  in  some  aspects  the  vis 
medicatrix  natura  works  on  passive  lines,  in  other 


172  THE  FOECB  OF  MIND 

aspects  its  operation  is  more  active,  as  by  the  destruc- 
tion of  noxious  agents  entering  the  body,  by  natural 
processes  of  expulsion  and  elimination,  by  compen- 
satory overgrowths,  and  by  a  slow  process  of  adapta- 
Theartof    tion  to  new  conditions.     But  for  the  natural  ten- 
de^uu  on  dencies  of  the  body  towards  health  when  disturbed  by 
the  •  vi».'     <jiseasej  the  art  of  healing  could  not  exist.' l 

It  is  evident  from  this,  that  though  the  '  vis  '  may 
be  represented  in  one  aspect  as  a  sort  of  inertia  that 
tends  to  restore  the  lost  balance  to  equilibrium,  it 
plays  other  parts,  in  which  it  appears  as  a  living 
preservative  force. 

Mitchell  Now  let  us  see  what  more  can  be  said  in  its  favour. 

wiSon    !>*•  Mitchell  Bruce  writes  : 2     'We  are  compelled  to 

m  favour     acknowledge  a  power  of  natural  recovery  inherent  in 

the  body — a  similar  statement  has  been  made  by 

writers  on  the  principle  of  medicine  in  all  ages.  .  .  . 

The  body  does  possess  a  means  and  mechanism  for 

modifying  or  neutralising  influences  which  it  cannot 

directly  overcome.' 3 

'  I  believe,'  he  continues,  '  that  a  natural  power  of 
prevention  and  repair  of  disorder  and  disease  has  as 
real  and  as  active  an  existence  within  us  as  have  the 
ordinary  functions  of  the  organs  themselves.' 

'  Every  thoughtful  practitioner,'  says  Dr.  Wilkin- 
son,4 'will  acknowledge  that  when  his  therapeutic 
reserves  are  exhausted  by  far  the  most  reliable  con- 
sultant is  the  vis  medicatrix  natures.  To  ignore  the 
fact  that  she  has  already  been  in  charge  of  the  case 

1  Dr.  A.  H.  Carter,  British  Medical  Journal,  Nov.  1900. 

f  Dr.  Mitchell  Brace,  Practitioner,  xcdv.  241. 

*  Ibid.  p.  248. 

4  Dr.  Wilkinson,  Lancet,  1897,  ii.  1518. 


THE  VIS  MEDICATEIX  NATURE          173 

for  days,  when  we  first  approach  with  our  mixtures 
and  tabloids,  is  at  least  a  mistake  in  medical  ethics.' 

'  The  vis  medicatrix  natures,'  he  also  says,  '  is  a 
power,  a  vital  resistance  to  disease.  Most  protective 
processes  are  grouped  together  as  "symptoms;" 
whereas  they  should  be  labelled  "  hereditary  treat- 
ment." ' 

We  may  proceed  to  examples : 

Consider  the  following  very  remarkable  facts  in 
proof  of  the  guidance  the  unconscious  mind  exercises 
over  the  growth  and  nutrition  of  the  body.  In 
extreme  old  age,  as  nutrition  gets  feebler,  the  bones 
are  wasted,  thinned,  and  softened.  But  the  bones  of 
the  skull  will  be  found  thicker  than  normal.  A  little 
consideration  will  show  that  there  must  be  a  centre 
able  to  arrange  the  manner  in  which  the  new  bone  is 
deposited  so  as  to  ensure  the  safety  of  the  brain,  even 
to  the  detriment  of  less  important  structures,  in  a 
manner  not  merely  mechanical. 

1  In  rickets  the  organism  does  not  get  enough  and  in 
lime  salts  to  build  up  the  skeleton  of  its  normal  n 
strength.  It,  however,  tries  to  make  it  as  strong  as 
possible  by  the  formation  of  bone  at  the  growing 
lines,  along  the  concavities  of  curves  and  at  such 
other  parts  as  transmit  a  greater  proportion  of 
weight.  Most  that  is  seen  in  rickets  is  the  result  of 
the  effort  made  by  the  organism  to  render  the  ill- 
nourished  skeleton  able  to  perform  its  mechanical 
work.  Except  for  this  effort  life  could  not  be  carried 
on.  In  the  skull  the  activity  of  the  organism  in 
meeting  the  condition  of  softened  bone  is  enormously 
and  efficiently  increased.  Observe  here  how  effec- 
tually nature  makes  the  best  application  with  its 


174  THE  FOECE  OF  MIND 

very  imperfect  material.     The  bone  is  most  abundant 
where  it  is  most  wanted.' l 

Our  ordinary  text-books  on  physiology  give  but 
little  idea  of  what  I  may  call  the  intelligence  that 
presides  over  the  various  systems  of  the  body, 
showing  itself  in  the  bones,  as  we  have  seen,  in 
distributing  the  available  but  insufficient  amount  of 
lime  salts  in  disease  ;  not  equally,  but  for  the  pro- 
tection of  the  most  vital  parts,  leaving  those  of  lesser 
value  disproportionally  deficient. 

This  selective  action  of  the  '  organism  '  forms  no 
part  of  any  property  of  matter,  but  is  essentially  a 
psychic  quality ;  in  short,  nothing  but  the  action  of 
the  unconscious  mind. 

Effect  of  Professor  Laycock  points  out  that  '  if  the  attention 

cornea.  is  daily  directed  to  an  opaque  cornea  during  a  hypnotic 
trance,  a  deposit  of  lymph  is  observed  to  form  accord- 
ing to  Miiller's  law,  "  that  a  structural  defect  tends  to 
be  removed  by  an  act  increasing  the  organic  action  of 
the  part." ' 

niu^r  In  aortic  obstruction  we  get  hypertrophy  of  the 

tiona  of  left  ventricle,  as  also  in  a  regurgitant  mitral,  com- 
pensation always  occurring  where  the  disease  cannot 
be  removed. 

A  blow  '  below  the  belt '  is  rarely  fatal  if  expected. 
The  eye  warns  the  mind  what  is  coming,  and  the  ab- 
dominal walls  instantly  become  rigid  without  conscious 
knowledge.  Also  in  peritonitis  the  walls  become  rigid 
to  protect  what  lies  beneath. 

The  swarming  of  leucocytes  after  bacteria,  and  the 
purposive  manner  in  which  they  work  their  way  to 

1  W.  Arbuthnot  Lane,  British  Medical  Journal,  November  7, 
1896,  p.  1365. 


THE  VIS  MEDICATRIX  NATURE        176 

the  seat  of  war,  speak  of  the  intelligent  protective 
mechanism  of  the  body,  of  which  innumerable  other 
instances  might  be  adduced. 

The  vis  medicatrix  natures  gives  power  to  the 
body  to  withstand  disease  in  many  ways,  not  only 
by  manufacturing  antitoxins,  but  in  increasing  the 
resisting  power  of  exposed  parts  of  the  body  by 
lessening  their  susceptibility.  The  skin  of  the  face 
is  as  thin  as  on  the  body,  but  is  seldom  susceptible  to 
chills,  &c.  In  connection  with  this,  Dr.  Clouston  Nerve 
points  out  that l  '  in  some  respects  the  influence  of  i^S 
the  brain  cortex  on  existing  diseases  in  any  organ  or  ]J8di 
tissue  and  in  warding  off  disease  is  measured  by  the 
amount  of  its  nerve  supply.  A  richly  innervated 
tissue,  like  the  skin  of  the  finger  pulps,  is  not  nearly 
so  liable  to  cutaneous  eruptions  as  the  less  endowed 
skin  of  the  back  and  limbs.  And  when  we  have  in 
the  same  organ  different  tissues  of  different  vitality 
and  innervation,  the  higher  and  the  more  innervated 
tissue  resists  the  effects  of  poisons  far  more  effectually 
than  the  lower.  Take,  for  example,  the  way  in  which 
the  alcoholic  or  the  syphilitic  poison  affects  the  brain 
and  the  liver.  They  do  not  touch  directly  the  nerve 
cells  or  fibres  or  the  hepatic  cells.  They  do  all  their 
pathological  damage  to  the  less  innervated  and  less 
active  connective  tissue  and  vascular  and  lymphatic 
constituents  of  these  organs.  The  neurine  and 
hepatic  tissues  proper  only  suffer  secondarily  by 
pressure  or  irritation.  It  seems  as  if  any  tissue 
might  effectually  resist  the  assaults  of  its  enemies  if 
it  had  nerve  influence  enough  from  the  brain  cortex.' 

'Whatever  other    theories    we    hold,   we    must 

1  Dr.  Clouston,  British  Medical  Journal,  January  18, 1896. 

N 


176  THE  FORCE  OF  MIND 

other         recognise  the  vis  medicatrix  naturce  in  some  shape 

monie.  to    or  other,'  says  Professor  0.  W.  Holmes. 

Jjj^*  '  Je  le  pansay  et  Dieu  le  guarit '  ('  I  dressed  the 

catrix        wound  and  God  healed  it ')  is  written  by  Ambroise 

Pare  on  the  walls  of  the  Ecole  de  Medecine  at  Paris. 

'  Nature  is  the  physician  of  disease,'  says  Hippocrates. 

'Keason  dictates   that  disease  is  nothing  else  but 

Nature's  endeavours  to  thrust  forth  with   all  her 

might  the  morbific  matter  for  the  health  of  the 

patient '   (Sydenham).      This  is  more  true  of  the 

symptoms  than  of  the  disease  itself. 

Sir  W.  S.  Church  speaks  of  our  old  friend  the 
goddess  '  Nature '  as  a  therapeutic  agent,  and  by  this 
time  we  know  to  whom  he  refers.  He  says : l  '  Did 
they  not  themselves  conduce  to  this  credulity  on  the 
part  of  the  laity  in  speaking  of  "  curing  "  disease  ? 
With  few  exceptions  they  did  not  cure  the  disease  any 
more  than  they  cured  a  broken  leg.  They  placed  the 
patient  in  the  best  circumstances  for  "  Nature "  to 
restore  the  health  of  the  ailing  person,  or  the  bone  of 
the  broken  leg.' 

1  Safety-  The  vis  medicatrix  naturce  has  been  traced  in  some 

lotions  in  detail  by  Dr.  Mitchell  Bruce.  He  gives  as  instances 
k^y-  various  '  safety-valve  '  actions  in  the  body — e.g.  the 
relief  of  cardiac  dilatation  and  distension  by  relaxa- 
tion of  the  arterial  walls  by  depression  of  the  cir- 
culation. If  this  fails  we  may  get  angina  pectoris, 
which  in  its  turn  is  relieved  by  nitrate  of  amyl,  dis- 
tending the  capillaries  in  imitation  of  this  action  of 
'  Nature.'  Again  :  '  Anorexia  in  gastric  catarrh  and 
hepatic  disturbance  giving  physiological  rest.' 

1  Sir  W.  S.  Church  at  opening  of  the  Yorkshire  College,  Leeds 
Britith  Medical  Journal. 


THE  VIS  MEDIOATEIX  NATUE^J        177 

Dr.  Bruce  points  out  that  in  contracted  kidney 
the  increased  arterial  pressure  favours  diuresis  and 
empties  the  veins :  so  that  the  body  here  modifies 
the  influence  it  cannot  overcome,  and  tries  to  remove 
the  effects  if  it  cannot  touch  the  cause. 

Other  instances  of  the  vis  medicatrix  naturce  are  other 
to  be  found  in  the  regulation  of  the  body  temperature,  STthJ*1*" 
which  allows  high  temperatures  to  persist  (as  is  now  '***' 
believed)  to  destroy  certain  toxins ;  also  in  the  com- 
pensating action  of   skin  and  lungs;    also  in  the 
repair  of  fractures,  in  sealing  up  poisonous  abscesses, 
in  forming  fresh  channels  of  circulation  when  the  old 
are  stopped  up.     Dr.  Bruce  finally  points  out  that 
this  '  vis '  is  possibly  acquired  through  evolution ;  that 
it  often  fails,  but  that  still  true  therapeutics  is  based 
upon  its  methods.    In  aortic  obstruction  or  mitral 
regurgitation  we  get,  as  I  have  said,    enlargement 
of  the  left  ventricle— i.e.  the  principle  of  vigorous 
reaction;    and  this  we  imitate  in  many  forms  of 
treatment  at  Nauheim  and  elsewhere. 

Vomiting  and  diarrhoea  in  dyspepsia,  and  cough  in  Hunger, 
bronchitis,   show  the  principle  of  direct  removal  of  dyspnoea 
cause.     Some  think  that  hunger,  thirst,  and  dyspnoea  fjj^he 
may  be  included  as  actions  of  the  vis  medicatrix 
naturce.    The  power  is  perhaps  seen  best  in  animals 
who  have  not  Harley  Street  to  call  in,  and  observe 
Nature's   treatment.    It  is  also  seen  in  savage  life. 
The  overwhelming  desire  for  sleep  in  some  nerve 
diseases  is  another  instance  of  it. 

If  we  take  Dr.  Charrin's  book,1  we  find  that  he  lays  Dr.  Char- 
down  in  systematic  fashion  the  various  factors  which 
1  Dr.  A.  Charrin,  Let  Defenses  Naturelks  d»  VOrganism*.  Paris, 

•  I 


178  THE  FOECE  OF  MIND 

assist  the  organism  in  resisting  the  attacks  of  the 
causal  agents  of  disease.  After  giving  a  general 
review  of  the  subject,  he  takes  in  order  the  condition 
of  the  blood  and  the  other  fluids  of  the  body,  and 
shows  what  an  important  action  these  may  have.  He 
then  discusses  the  various  glands,  especially  those 
that  have  special  functions,  such  as  the  thyroid  and 
the  suprarenal  bodies,  and  shows  how  in  all  proba- 
bility they  exert  a  marked  influence  on  the  removal 
and  neutralisation  of  the  poisonous  products  formed 
as  a  result  of  ordinary  metabolic  processes.  In 
considering  the  spleen  he  treats  of  it  in  its  relation 
both  to  the  composition  of  the  blood  and  to  the 
elimination  of  certain  poisons  from  the  body.  Then, 
leaving  the  special  glands,  he  takes  up  the  considera- 
tion of  our  defences  against  thermal  conditions, 
especially  those  connected  with  the  nervous  and 
vasomotor  systems.  The  secretions  of  the  nasal 
fossae,  the  bucco-pharyngeal  cavities,  the  gastric  and 
intestinal  juices,  the  pancreatic  and  the  hepatic 
secretions  are  all  discussed  in  turn,  and  their  import- 
ance insisted  upon.  The  secretions  of  the  kidney  are 
also  carefully  analysed,  and  the  variations  as  regards 
the  nature  of  the  toxieity  of  the  urine  considered. 
Finally,  there  are  a  chapter  on  the  nervous  system  and 
a  summary  of  the  defences  outside  the  organism. 
Three  It  is  evident  that  in  a  work  of  this  kind  three 

questions  must  constantly  be  coming  to  the  front — 
phagocytosis  ;  the  destruction  by  the  various  cells  of 
the  body  of  natural  and  disease  products  ;  and  lastly, 
the  production  and  action  of  various  antitoxins,  using 
the  term  « antitoxin '  in  its  very  widest  sense,  as  it  is 
employed  by  Bouchard.  Dr.  Charrin  has  treated  each 


questions 
raised. 


THE  VIS  MEDICATEIX  NATURE        179 

part  of  his  subject  with  a  certain  degree  of  thorough- 
ness, and  I  can  promise  any  one  who  will  carefully 
read  through  this  work  that  he  will  rise  from  its 
perusal  with  a  feeling  of  astonishment,  not  that  he 
escapes  disease,  but  that  he  should  ever,  by  any 
chance,  become  affected.  So  much  for  the  vis  medi- 
catrix  natures ! 

The  most,  then,  a  doctor  can  do  is  to  assist  the  The  vi» 
body  in  making  use  of  this  great  power,  which,  we  Jjf"*- 
may  once  more  repeat,  is  really  nothing  more  than  the  natwa  is 
action  of  the  unconscious  mind.     The  '  vis '  is  a  fine  ^?ow°°n' 
illustration   of  the  power  of  the   mental  factor  in  mind< 
Pathology  if  not  in  Medicine.     So  great  indeed  is  this 
natural  power  that  not  the  most  skilled  combination 
of  drugs  is  of  any  avail  without  its  aid,  while  the 
most  haphazard  remedies  of  the  purest  empiricism 
can  accomplish  marvels  if  backed  by  this  ever-present 
force.     But  for  this  marvellous  power,  a  morbid  dis-  Treatment 
turbance  once  set  up  would  inevitably  continue  to  the  ^tSTft 
point  of  annihilation  ;  for  treatment  addressed  to  the 
living  body  is  absolutely  meaningless  except  as  an 
appeal  to  such  powers  of  resistance  as   a  patient 
possesses.    When   these  powers  of  the  unconscious 
mind  fail,  as  in  the  closing  scenes  of  any  fatal  illness, 
it  is  idle  to  expect  anything  from  treatment,  as  of 
course  we  all  know  death  really  is  the  result  of  the 
failure  of  the  vis  medicatrix  naturae. 

Sir  Lauder  Brunton  may  fittingly  close  this  brief  I^JjJ*" 
survey  of  the  vis  medicatrix  natura  with  the  follow-  On  the 
ing  interesting  illustration  of  its  physiological  power.1  j^ti^'in6 
'How  is   it,'   he  asks,    'the  ferments  which  form  &«**<*• 
poisons   do  not  pass   into   the  blood,  and  kill   the 

'  Sir  Lander  Brunton,  Disorders  of  Assimilation,  1901,  pp.  8  Mid  6. 


180  THE  FOECE  OP  MIND 

animal  by  digesting  the  tissues,  and  forming  poisons 
from  them  ? 

'In  all  probability  the  reason  ...  is  ...  that 
they  are  altered  from  active  enzymes  to  inert 
zymogens,  which  can  be  stored  up  without  risk  ;  and 
can  again  liberate  active  enzymes  when  .  .  .  required. 
In  this  respect  they  may  be  compared  to  the  knives 
used  by  wandering  people,  by  whom  they  are  not 
thrown  away  after  each  meal  .  .  .  but  put  into 
sheaths  which  cover  their  edges. 

And  on  'Possibly  we  may  discover  also  that  immunity, 

immunity.    naturaj  or  acquire^  is  nothing  more  than  an  extension 

to  the  cells  of  the  tissues  generally  of  a  power  which 

is  constantly  exercised  during  digestion  by  those  of 

the  intestines  and  liver.' 

Nature's  The  wonders   of  'Nature's'   therapeutics   (or  of 

pnltiM  ^e  mental  factor  in  medicine),  Professor  Potter,  of 
Philadelphia,  declares,  '  are  worthy  of  a  professor's 
chair.' 

Perhaps  at  present  one  of  the  best  unconscious 
demonstrations  of  its  powers  is  to  be  seen  wherever 
true  homoeopathy  in  its  minute  dilutions  is  faithfully 
practised.  This,  however,  requires  a  long  search  to 
find  nowadays. 

The  vit  I  have  considered  the  vis  medicatrix  natura  as 

££***       being  a  well-known   and   defined  form  of  natural, 

n^uro»u    mental,    protective,   and  remedial    action,   but  my 

readers  will  remember  I  have  pointed  out  that  this, 

after  all,  forms  but  a  part  of  the  mental  factor  in 

therapeutics.    If,  then,  I  leave  this  subject  now,  it 

must  not  be  thought  that  the  stream  of  testimony  to 

the  healing  power  of  the  mind  over  the  body  has 

therefore  run  dry. 


THE  VIS  MEDIOATEIX  NATUE^J        181 

I  will  now  consider  some  evidence  of  a  general 
nature  as  to  the  way  in  which  the  natural  powers 
of  the  unconscious  mind  may  be  augmented  by  mental 
therapeutics ;  and  to  any  disposed  to  think  the  testi- 
mony needlessly  prolix  or  redundant,  I  would  say, 
'  Consider  for  a  moment  that  the  little  book  you  hold 
in  your  hand,  with  its  many  defects,  is  after  all 
probably  the  only  attempt  in  this  country  in  recent 
years  to  present  this  mental  factor  as  an  agent  in  the 
cause  and  cure  of  disease.  If  there  are  others,  I  have 
not  found  them,  and  should  be  very  glad  to  hear 
of  them.  Meanwhile,  even  at  the  possible  risk  of 
boring  some  of  my  readers,  proof  must  be  piled  upon 
proof,  testimony  upon  testimony,  in  order  that  out  of 
the  mouths  of  many  witnesses  the  facts  may  be 
established. 

Though,  however,  there  may  be  no  modern  works 
upon  the  matter,  there  are  plenty  of  scattered 
allusions  to  it  in  older  books,  for  the  subject  at  any 
rate  is  not  a  modern  one,  but  is  as  old  as  medicine 
itself. 

The  antiquity  of  mental  therapeutics  is  indeed  Kg  ^ 
great.     In  the  oldest  civilisation  with  which  we  are  J?mqenui 
acquainted,  that  of  Egypt,  it  had  a  prominent  place.  £*^ 
Colquhoun,   quoted    by  Gliddon,    remarks:    'Their 
priests  evidently  appear  to  have  perfectly  compre- 
hended the  method  of  exciting  that  internal  sanative 
instinct  in  the  human  organism  which  in  general  is 
a  profound  mystery  even  to  the  individual  who  ex- 
cites it ;  and  which  was,  therefore,  naturally  enough 
perhaps   in  those  remote  ages,  represented  as  an 
immediate  gift  of  the  gods.    Nowhere  was  this  in- 
ternal faculty  so  generally  cultivated  for  the  cure  ol 


182  THE  FORCE  OF  MIND 

the  sick,  as  also  for  other  affairs  of  this  life,  as  in 
Egypt.' l 

Greece  md  The  excavations  at  Cavvadias  have  furnished  us 
Rome<  with  much  interesting  material,  showing  that  the 
miraculous  cures  of  Epidaurus  were  effected  at  this 
ancient  Greek  shrine  five  hundred  years  before  our 
era,  precisely  in  the  same  manner,  and  by  suggestion, 
as  in  our  times  at  Lourdes. 

Livy  tells  us  that  the  temples  of  the  gods  of  Eome 
were  rich  in  the  number  of  offerings  which  the  people 
used  to  make  in  return  for  the  cures  received  from 
them ;  and  Pliny  tells  of  Etruscan  spells  used  by 
Theophrastus  for  sciatica,  by  Cato  for  the  cure  of  dis- 
located limbs!  and  by  Varro  for  gout.  Our  own 
Druids,  using  similar  methods,  were  consulted  by  the 
Emperor  Aurelius. 

Sir  Andrew        But  coming  to  more  modern  times,  Sir  Andrew 

Shew  rad    Clark  savs  :  2 '  I*  is  impossible  for  us  to  deal  knowingly 

menui       and  wisely  with  various  disorders  of  the  body  without 

peutto.       distinctly  recognising  the  agency  of  states  and  conditions 

of  mind,  often  in  producing  and  always  in  modifying 

them.'     '  The  reaction  from  the  ancient  metaphysical 

view  of  medicine  has  been  carried  too  far.' 3    This 

last  refers  to  the   switchback  method   of    progress 

common  to  human  science,  already  alluded  to. 

'  Up  to  the  very  gates  of  death  I  maintain  that  a 
sanguine,  cheerful,  and  hopeful  expectation  is  infinitely 
more  useful,  and  more  warrantable  on  the  part  of  the 
physician,  than  a  brutal  candour,  which  may  cut  the 
Blender  thread  that  holds  the  vital  powers  together.' 4 

•  Gliddon,  Faith  Cures,  p.  8. 

•  Sir  A.  Clark,  Lancet,  1855,  ii.  315. 

•  Dr.  A.  Morrison,  Practitioner,  1892,  p.  26.  4  Ibid.  p.  40. 


THE  VIS  MEDICATEIX  NATURE        183 

'  In  actual  danger  of  death,  the  sense  of  safety  is 
often  a  saving  cause.' ! 

Dr.  Maudsley  says : 2  « Perhaps  we  do  not  as 
physicians  consider  sufficiently  the  influence  of  mental 
states  in  the  production  of  disease,  their  importance  as  Playfa'ir- 
symptoms ;  or  take  all  the  advantages  which  we  might 
get  from  them  in  our  efforts  to  cure  disease.  Quackery 
seems  to  have  got  hold  of  a  truth  which  legitimate 
medicine  fails  to  appreciate  or  use  adequately.' 

Dr.  Granville  adds : 3  '  Except  in  a  loose  and 
vague  way  the  potent  influences  exercised  reflexly 
by  the  mind  upon  the  body  are  scarcely  regarded 
as  falling  in  with  the  scope  of  pathology.' 

Dr.  K.  Brudenell  Carter  points  out  that  '  the 
good  physician  must  be  a  student  of  human  nature. 
When  he  becomes  a  clinical  clerk,  he  must  think 
of  the  mental  characteristics  of  his  patients. 

'  He  will  find  it  possible  to  use  the  mind  '  (uncon- 
sciously) '  of  almost  every  patient  as  an  instrument  for 
promoting  the  recovery  of  his  body.  There  are  some 
patients  with  whom  you  may  enter  into  a  sort  of 
intellectual  partnership,  explaining  what  you  want 
them  to  do.' 

Dr.  Playfair  says : 4  *  The  tendency  of  advanced 
medicine  of  the  present  day  is  unfortunately  to  over- 
look cure  in  the  zeal  for  accurate  diagnosis  and 
correct  pathology.  In  short,  it  is  science  rather  than 
therapeutics  that  is  the  aim.' 

Dr.  Brudenell  Carter  again  observes : 6  '  There  is 

Sir  B.  Ward  Richardeon,  Asckpiad,  1890,  p.  833. 

*  Dr.  Maudsley,  Mind  and  Body,  i.  38. 

*  Dr.  Mortimer  Granville,  Lancet,  1879,  i.  580. 

*  Dr.  Playfair,  British  Medical  Journal,  1886. 

*  Dr.  Brudenell  Carter,  Lancet,  1873,  ii.  484. 


184  THE  FOECB  OF  MIND 

Carter,       one  branch  of  special  study  that  demands  the  closest 

Sdwffi  attention  ;  and  that  is  the  study  of  the  varieties  of 

human    temperament    and    character,   so    that    we 

may  learn  to  use  the  mind  of  each  patient  as  an 

instrument  for  promoting  the  recovery  of  his  body.' 

Dr.  Eobertson  says  :  '  '  While  the  influence  of  the 
mind  over  the  body  is  universally  recognised,  its 
employment  as  a  therapeutic  agent  is  purposely  used 
by  but  a  few  in  the  regular  ranks  of  the  profession.' 

Sir  S.  Wilks  remarks  :  '  The  doctor  soon  finds  that 
in  treating  his  patient  the  practice  of  medicine  is  not 
only  one  of  physic  but  of  psychology  ;  and  that  the 
effect  of  his  drugs  depends  as  much  upon  the  con- 
stitution of  the  patient's  mind  as  on  that  of  his  body.' 
Dr.  Shoe-  Dr.  Shoemaker,  of  Philadelphia,  says  :  2  '  Psycho- 
Dr.  Dale!  therapism  plays  a  most  important  part  in  the  ordi- 
nary every-day  practice  of  medicine.  The  influence 
of  the  mind  upon  the  bodily  functions  is  so  great  that 
every  experienced  intelligent  physician  is  glad  to 
enlist  so  potent  an  auxiliary.' 

Dr.  Dale,  however,  considers  that  'the  use 
physicians  can  make  of  the  influence  of  the  mind 
over  the  body  in  curing  disease  is  very  small  indeed  ;  ' 
a  proof,  if  proof  were  needed,  of  the  weakness  of  the 
conscious  mind  (to  which  he  alludes)  in  this  direction, 
as  compared  with  the  power  of  the  unconscious. 


catheii  A  b°°k  by  "Dr*  Catne11  on  tlie  reputation  and 

and  success  of  a  physician  insists  in  nearly  every  one 

ciouBton.     of  300  pageg  Qn  the  mental  factor  in  the   cures 


effected. 

Dr.  Clouston  says  :  *  In  the  treatment  of  all  di*- 

1  Dr  Eobertson,  Lancet,  1894,  iL  408. 
*  Dr.  Shoemaker,  Therapeutics,  p.  1013. 


THE  VIS  MEDICATBIX  NATUE^J        186 

eases,  the  influences  travelling  to  and  from  the  brain 
cortex  must  be  taken  into  account.' 

J.  H.  Sealy  in  1837  writes : l  '  I  shall  now  con-  Dr.  s^aiy 
sider  the  mind  as  a  source  of  cure  and  as  an  agent 
equally  potent  and  as  frequently  used  for  the  removal 
of  corporeal  malady,  as  I  have  shown  it  to  be  active 
in  its  production.' 

Sir  John  Forbes  writes  : 2 '  Means  acting  directly 
on  the  mind,  and  influencing  other  parts  of  the  body 
through  it,  form  an  important  class  of  remedies,  and 
occupy  a  much  larger  space  in  actual  therapeutics 
than  is  commonly  believed,  and  deserve  to  occupy  a 
still  larger.  Their  operation  is  fully  as  powerful  and 
effective  in  disease  of  a  purely  bodily  character  as  in 
mental  disease.' 

Tuke  says : 3 '  The  mind  or  brain  excites,  paralyses,  Tuke, 
or  depresses  the  sensory,  motor,  vasomotor,  and  trophic 
nerves,  and  through  them  causes  changes  in  sensa- 
tion, muscular  contraction,  nutrition,  and  secretion.' 

H.  G.  Sutton  writes : 4  '  We  must  remember  when 
our  aim  is  to  relieve  the  sufferer  we  must  not  leave 
his  mind  out  of  court.' 

Dr.  Beard  says  :  '  The  ill  success  of  patients  who 
treat  themselves  or  physic  their  families  is  due  to  the 
absence  of  the  mental  factor.' 

We  read  in  '  The  Lancet : ' "  '  Though  the  thera- 
peutic effect  of  faith  and  hope  is  not  detailed  in  our 
text-books,  they  are  enough  often  to  turn  the  scale  in 
favour  of  recovery ;  and  yet  they  are  but  two  of  the 

Dr.  J.  H.  Sealy,  Medical  Essays,  ii.  76. 

Sir  John  Forbes,  Nature  and  Art  in  Disease,  p.  19& 

Dr.  Hack  Tuke,  Mind  and  Body. 

Dr.  H.  G.  Sutton,  Pathology,  p.  487. 

The  Lancet,  January  1883. 


186  THE  FOECE  OF  MIND 

many  mental  medicines  which  a  judicious  physician 

may  use  in  the  management  of  disease.' 

The  effect          So  far  we  have  but  touched  on  the  effect  of  the 

dLSfr's       patient's  mind  upon  his  disease,  either  in  its  natural 

""ad          action,  or  as  stimulated  by  mental  therapeutics  ;  but 

the  mental  factor    in    disease    may  have  a  wider 

meaning,  and  include  the  effect  of   the  doctor,  and 

the  doctor's  personality  and  mind,  in  its  unconscious 

or  sub-conscious  influence  upon  the  patient's  mind ; 

and  through  this,  unconsciously  upon   the   physical 

ailment.    The  chain  may  seem  a  long  one,  but  it  is 

traversed  instantaneously  in  every  interview  between 

wility.      doctor  and  patient. 

We  will  give  the  testimony  of  one  or  two  on  this 
head. 

Dr.  Affleck  says  : l  '  The  power  of  suggestion  as  a 
factor  hi  therapeutics  has  gained  wide  recognition  in 
recent  times. 

'The  numerous  directions  in  which  it  may  be 
exercised  are  better  realised  by  some  practitioners 
than  by  others.  But  there  is  one  manifestation  of  it 
which  applies  to  the  case  of  all :  that  is,  the  personality 
and  moral  influence  of  the  physician  in  his  relations 
T*1116  th  *°  n*8  P^ents.  It  may  indeed  be  difficult  or  impos- 
sible to  appraise  the  abstract  therapeutic  value  of  the 
output  of  his  sympathy  and  the  tone  which  may  be 
imparted  to  his  ministrations.  But  when  these  are 
dictated  by  the  highest  motives  which  can  inspire 
a  life,  they  are  laden  with  true  healing  virtue  to  the 
sufferer,  they  tend  to  exalt  the  physician's  office  in 
the  estimation  of  mankind.' 

1  Dr.  Affleck,  Edinburgh  Meeting  of  British  Medical  Association, 


THE  VIS  MEDICATRIX  NATURE        187 
'  A  day  will  come,'  says  De  Fleury,1  '  when  there  Prophecy 

of 

De  Fleury. 


shall    arise    an   upright  and  intelligent   physician,  of 


strong  enough  to  defy  ridicule,  and  authorised  by  a 
noble  life  and  the  merit  of  his  labours  to  lay  claim 
to  the  superior  dignity  of  a  moralist.  If  he  knows 
the  human  heart  well  he  can  draw  the  sick  of  soul  to 
him.'  '  The  sound  medical  moralist  might  be  able  to 
double  the  amount  of  voluntary  energy  and  moral 
strength  in  us  all.' 

Dr.  A.  Morrison,  President  of  the  .ZEsculapian 
Society,  says  : 2  '  We  often  do  less  than  half  our  duty 
in  not  exploring  the  mental  life  of  the  patient.  ...  A 
good  deal  has  been  written  on  prolonged  vascular 
tension  due  to  physical  causes.  Is  there  no  such 
state  as  prolonged  mental  tension  due  to  moral 
causes  ?  ...  In  such  cases,  if  the  physician  is  to  be  of 
any  service  to  his  patient,  it  must  be  by  the  agency  of  littered 
mind  on  mind ;  and  this  takes  us  out  of  the  vestibule 
littered  with  microscopes,  crucibles,  and  retorts  into 
that  inner  chamber— the  holy  of  holies  in  the  life  of  a 
physician  and  his  patients — where  heart  and  mind  are  The 
laid  bare  to  the  sympathetic  gaze  of  a  fellow-man,  mental 
whose  discretion  may  be  relied  on,  and  who  may  from 
his  training  in  the  knowledge  of  the  human  soul  as  well 
as  the  human  body  be  able  to  cure  his  brother  of  a  dis- 
turbing factor  in  his  life  beyond  the  reach  of  the  most 
advanced  therapeutics  of  a  purely  physical  kind.' 

Dr.  Gordon  Sharp  writes:3  'Above  all,  the  per- 
sonality  of  the  physician  is  to  be  remembered ;  for 

1  Dr.  De  Fleury,  Medicine  and  Mind  (Prize  Essay  of  the  French 
Academy),  p.  224. 

1  Dr.  A.  Morrison,  The  Practitioner,  1892,  p.  27. 
»  Dr.  Gordon  Sharp,  Lancet,  1894,  i.  1557. 


188  THE  FOECB  OF  MIND 

gome  men  can  work  wonders  by  means  of  almost  any 
drugs,  whilst  another  medical  man  with  a  chemist's 
shop  fails  to  relieve  his  patient.' 

'The  Lancet'  (January  1883)  says:  'A  full 
recognition  of  the  value  rightly  attaching  to  the 
mental  treatment  of  physical  ailments  will  improve 
the  usefulness  of  the  physician,  give  him  a  higher 
place  in  the  affections  of  his  patients,  and  materially 
assist  in  promoting  their  return  to  health  when 
suffering  from  very  various  diseases,  functional  or 
organic.' 

Dr.  Sealy  writes  :  '  Without  the  full  confidence  of 
the  patient,  no  physician  should  continue  to  attend 
his  patient.' 

Some  last         One  of  the  last  words  of  Henry  Gawen  Button, 
D^'H.°G.    m7  teacher  of  pathology  at  the  London  Hospital,  was : 
Button.       t  Don't  underrate  the  influence  of  your  own  person- 
ality.   Learn  to  give  confidence  to  your  patients.'    A 
presence  is  of  course  felt  in  proportion  to  its  power. 
'0  lole,  how  did  you  know  Hercules  was  a  god?' 
'  Because  I  was  content,  the  moment  my  eyes  fell  on 
him — he  conquered  whether  he  stood,  or  walked,  or  sat.' 
Psycho-  To  constrain  a  feeble  brain  to  be  governed  by  a 

ictiot1  S°°d  one  ig  no*  a  superhuman  labour  for  one  who 
through  goes  about  it  adroitly.  The  moment  the  eye  of  the 
patient  meets  the  eye  of  the  physician,  psychological 
action,  influencing  the  course  of  the  disease,  at  once 
takes  place  through  the  patient's  unconscious  mind. 
The  depression  caused  by  the  doctor's  bad  manners  or 
gloomy  looks  may  be  combated  actively  by  the  patient's 
reason,  and  will  yet  have  a  bad  effect,  malgre  lui,  on 
his  body  through  the  unconscious  mind,  or  *  instinct.' 
Just  as  with  our  material  science  and  physical  skill 


THE  VIS  MEDICATEIX  NATURE        189 

we  seek  by  drugs  and  other  agents  to  influence  the 
body  for  good,  so  invariably  (and,  as  I  have  said, 
most  often  unconsciously)  does  the  physician's  mind 
influence  that  of  the  patient.     The  '  gift  of  healing '  The  '«ft 
that  some  men  seem  to  possess  to  a  marvellous  extent,  of  he^ng>' 
so  that  few  sick   can  leave  their  presence  without 
feeling  better,  is  a  purely  unconscious  psychic  quality, 
at  any  rate  in  its  origin  ;  though,  like  other  gifts,  it 
can  of  course  be  perfected  by  use. 

Manner  is  much  in  medicine,  and  the  personal  Mann«in 
presence  is  a  power  in  practice,  and  both  are  worthy  medioilM- 
of  a  serious  consideration  they  seldom  get. 

The  effect  on  the  patient's  mind  varies  of  course 
much  with  the  patient's  temperament,  as,  indeed,  all 
know.  Moreover,  those  acquainted  with  the  natural 
history  of  disease  know  well  that  a  particular  malady 
in  a  patient  of  sanguine  temperament  may  be  looked 
on  more  favourably  than  in  one  of  a  phlegmatic 
constitution.  In  the  former  case  we  can  rely  on  a 
resiliency  which  will  fail  us  at  the  critical  moment 
in  the  other. 

But  I  must  bring  this  long  and,  I   fear,  some-  Condu- 
what  wearisome  chapter  to  a  close ;  trusting  I  have  ilon' 
succeeded  by  the  mouths  of  many  witnesses  in  fully 
establishing  my  thesis  that  there  is,  after  all,  a  large 
and  weighty  body  of  testimony  '  to  the  presence  and 
importance  of  the  vis  medicatrix  natures  and  to  the 
general  power  of  mind  over  disease.' 


190  THE  FOBCE  OF  MIKD 


CHAPTEB  XI 
80M3   VARIETIES  OF  MENTAL  THERAPEUTICS 

•The  effective  agent  in  all  faith-cure*  is  the  nneon- 

•cions  mind.' 

IT  may  perhaps  form  an  interesting  introduction  to 
this  chapter  if  we  glance  at  that  ride  of  mental 
therapeutics  that  appeals  to  the  doctor  personally, 
and  consider  for  a  moment  its  value  to  himself  aa 
well  as  to  his  patient. 

Doctors  are,  indeed,  the  most  rniflfllfiah  of  men 
(though  this  is  not  perhaps  the  place  to  say  so),  but 
they  are,  after  all,  very  human. 

The  lofty  altruistic  note  which  is  regularly  struck 
at  the  inaugural  October  lectures  for  the  benefit  of  the 
neophyte  is,  as  a  rule,  too  high  for  the  somewhat 
sordid  mind  of  the  average  medical  student,  and  it  is 
interesting  to  observe  how  it  gradually  lowers  in 
purity  and  pitch  as  his  ideal  slowly  rises;  until 
at  last  the  approximation  of  the  two  yields  the 
practical  keynote  of  ordinary  medical  life.  This  life, 
after  all,  is  governed  by  very  mixed  motives,  in  which 
the  sordid  necessities  of  existence  perforce  find  a 
hearing  in  common  with  the  highest  impulses  of 
a  noble  philanthropy. 


VABIETIES  OF  MENTAL  THEBAPEDTICS    191 

Very  various  and  complex  indeed  are  the  forces  iww 
that  underlie  the  conduct  of  upright  and  honourable  £,££! 
men ;  the  utterly  vicious  on  the  one  hand,  and  the 
self-deceived,  the  visionaries,  and  the  fanatics  on 
the  other,  know  less  of   the  balance  of  opposing 
forces  that  make  for  sanity.     It  is  only  the  latter, 
indeed,  who  think  they  really  live  by  the  impulse 
of  a  single  motive.     '  A  single  eye  *  but  postulates 
at  best  a  controlling  motive;  the  subordinate  ones 
are  all  also  needed  to  total  up  an  honest  man's  life. 

AH  this  leads  up  to  the  truth  that  the  power  MOW 
possessed  by  the  mental  factor,  when  rightly  used,  ***** 
becomes  not   only  an  agent  of   untold  good  to  the 
patient,  but  no  small  part  of  the  cause  of  the  physi- 
cian's success. 

An  editorial  in  the  'Medical  Times1  for  1872 
says :  '  The  question  how  mental  influences  may  T*M«<» 
be  practically  applied,  controlled,  and  directed  for  Si****" 
therapeutical  purposes  is  certainly  one  well  worthy 
the  pursuit  of  the  scientific  physician. 

'We  question  if  we,  as  a  profession,  sufficiently 
study  the  art  of  inspiring  confidence  of  recovery. 
We  know  that  inert  substances,  under  a  confident 
expectation  of  their  producing  certain  effects,  will 
often  act  as  purgatives,  narcotics,  or  sedatives. 

'  How  much  more  would  the  well-directed  efforts  of 
the  physician  produce  these  effects  with  certainty  if 
aided  by  probably  the  most  powerful  therapeutic  fore* 
in  the  human  organism !  *  (The  italics  are  mine.) 

Sir  J.  C.  Browne  says :  *  '  The  success  or  failure 
of  a  practitioner  will  often  depend  as  much  on  his  BTOI 

1  Sir  James  Criehton  Browne,  British  Medical  Jotumal,  1889, 
ii.  lOt 


192  THE  FOECE  OF  MIND 

experience  as  a  medical  psychologist  as  on  his  skill 
in  simples.' 

And  further  : '  '  The  general  medical  practitioner 
has  to  have  regard  to  the  psychological  condition  out 
of  which  corporeal  diseases  grow,  and  by  which  their 
course  may  be  beneficially  or  injuriously  affected.' 

Professor  Bowen  says  : 2  '  After  poisoning  their 
patients  with  drugs  through  many  centuries,  the 
doctors  have  at  last  come  to  know  their  business 
better ;  and  now  generally  stand  aside,  so  as  to  leave 
free  course  to  the  curative  agencies  of  the  unconscious, 
which  alone  can  restore  the  patient  to  perfect  health.' 
AIK>  The  An  editorial  in  '  The  Lancet '  (1883)  says  :  '  The 
Lancet.  Doctrine  that  a  favourite  drug  is  useful  for  a  particular 
disease  may  be  found  fallacious  if  the  mental  con- 
dition of  the  patient  be  overlooked  ;  and  one  chief 
difference  between  the  thoughtful,  intellectual,  and 
successful  physician,  and  another  who  is  neither, 
is  the  attention  which  the  first  devotes,  perhaps  un- 
consciously, to  this  factor  in  the  case.' 

But  why,  may  we  ask,  should  not  the  unhappy 
man  '  who  is  neither '  have  been  helped  and  instructed 
in  his  student  days  in  a  knowledge  of  such  an  im- 
portant condition  of  success  ? 

And  th«  Cassiodorus  ('  Ep.'  lib.  i.)  says  :  '  To  give  joy  to 

ancients,      the  sick  is  natural   healing ;   for  once  make  your 
patient  cheerful,  and  his  cure  is  accomplished.' 

Celsus  (lib.  iii.  cap.  6)  says :  '  It  is  the  mark 
of  a  skilled  practitioner  to  sit  awhile  by  the  bedside 
with  a  blithe  countenance.' 

1  Sir  J.  C.  Browne  at  Leeds,  British  Medical  Journal,  1889, 
ii.  400. 

1  Professor  Bowen,  Modern  Philosophy,  p.  849. 


VAEIETIES  OF  MENTAL  THEKAPEUTICS    193 

Solomon  says  (Proverbs  xvii.  22) :  'A  merry  heart 
doeth  good  like  a  medicine.' 

Truly  these  ancients  understood  the  value  of  the 
doctor's  face  in  disease,  and  with  them  agree  also 
the  wiser  of  the  moderns.  Hear  Dr.  Oliver  Wendell 
Holmes,  when  he  appraises  its  commercial  value: 
'  A  smile  may  be  worth  5,000  dollars  a  year  to 
a  man ' ! 

I  presume  he  means  a  smile  a  visit,  or  at  least 
one  a  day  ;  or  perhaps  he  may  picture  a  smile  com- 
menced with  the  professional  career,  and  continuing 
in  storm  and  calm,  unruffled  throughout  its  course ! 

I  wonder  if  physicians  as  a  rule  have  really  any  The  pow« 
conception  of  the  power  of  the  face  over  the  patient ; 
how  closely  it  is  watched,  and  more  deduced  from  the 
aspect  and  manner  than  from  the  words. 

Some  have  the  faculty,  as  we  say,  instinctively 
(which  simply  means  by  the  action  of  the  unconscious 
mind),  of  adapting  themselves  in  voice,  manner,  and 
expression  to  the  needs  of  the  patient  before  them, 
so  that  these  shall  produce  their  highest  therapeutic 
effects  ;  and  there  can  be  no  doubt  that  what  is  thus 
instinctive  is  at  once  more  natural  and  more  effective 
than  what  is  consciously  assumed.  It  is  undoubtedly 
this  natural  gift  that  is  the  great  secret  of  success. 

But  the  man  who  has  not  got  this  may  do  much, 
once  he  grasps   the  value  of   the  mental   factor  in 
medicine.     He  can,  at  any  rate,  so  discipline  and  train 
himself  as  to  infuse  three  ideas  into  the  patient's  thep»tient 
mind  at  every  visit. 

1st.  That  the  case  has  his  whole  and  undivided 
attention. 

2nd.  That  he  thoroughly  understands  it,  and— 

oi 


194  THE  FOECE  OF  MIND 

3rd.  That  he  believes  he  can  cure  it,  or,  at  any 
rate,  takes  a  hopeful  view  of  it. 

There  are  of  course  in  every  doctor's  experience 
ead  occasions  when  the  last  is  impossible,  but  these 
are  rare. 

DM.  Rush  Dr.  Eush  never  prescribed  remedies  of  doubtful 
Ficu^on  efficacy  in  the  various  stages  of  acute  disease  till  he 
mental  ^ad  worke(j  up  Qis  patients  with  a  confidence  border- 

influence.  *  A 

ing  on  certainty  of  their  probable  good  effects.  The 
success  of  this  measure  has  much  oftener  answered 
than  disappointed  his  expectation. 

In  neglecting  the  systematic  and  scientific  employ- 
ment of  mental  influence  in  the  course  of  disease, 
medical  practitioners  throw  aside  a  weapon  for  com- 
bating it  more  powerful  than  all  the  drugs  in  the 
Pharmacopoeia. 

'  It  must  be  acknowledged '  (however),  says  De 
Fleury,1  '  that  the  higher  hygiene  which  I  propose 
can  only  be  exercised  efficaciously  by  a  tete-d-tete 
in  the  consulting-room  of  a  specialist,  and  that  it 
actually  is  lay  confession  without  prestige  and  without 
poetry.' 

Value  of  a         Men  who  cultivate  a  hopeful  demeanour  in  the 
w™teu       sick-room  will  more  readily  restore  the  patient  by  this 
nftnce,        helpful  buoyant   spirit  than  others  who  are  consti- 
tutionally grave  and  desponding.      These  often  un- 
wittingly hinder  the  cure  they  are  anxious  to  promote. 
I  give  an  instance  of  this  in  Chapter  XVI. 

Indeed,  so  great  is  the  mental  factor  in  therapeutics, 
that  it  is  not  too  much  to  say  that  inferior  medical  skill 
with  a  good  and  assuring  manner  is  more  likely  to 

1  Dr.  de  Fleury,  Medicine  and  the  Mind,  p.  222. 


VAEIETIES  OF  MENTAL  THEEAPEUTICS    195 

effect  a  cure  than  a  superior  skill  with  a  diffident 
and  depressing  personality. 

Sympathy  is  indeed  a  powerful  drug  in  the  hands  and  of 
of  a  skilful  administrator  ;  for,  after  all,  patients  think  §ynipathy- 
much   more  of  the   doctor    than  his  prescriptions; 
while    he— poor   man— generally   thinks   his   hiero- 
glyphics all,  and  himself  nothing. 

Success  largely  depends  upon  our  striking  the  key- 
note of  the  characters  we  have  to  deal  with.  'In 
nerve  disease,'  says  Coleridge,  '  he  is  the  best  physician 
who  knows  best  how  to  inspire  hope.' 

A  wise  doctor  pays  many  visits  that  are  not 
confined  to  strictly  professional  topics ;  for  in  them 
the  doctor  learns  much,  as  the  unconscious  mind 
displays  itself  before  him. 

It  is  thus  that  a  family  physician  in  the  first  Vain«of 
instance  has  the  greatest  opportunities  of  mental 
treatment.  His  blue  pill  may  be  useful,  but  his  tact 
in  encountering  false  notions  and  instilling  healthy 
ideas  is  the  most  powerful  remedial  agent  he 
possesses. 

There   are   at  least  four  ways  by  which  mental  FOOT 
therapeutics  can  be  applied  to  disease. 

1.  By  the  direct  active  power  of  the  unconscious 
mind   inherent   in   itself,  and   generally    called   the 
vis  medicatrix  natures. 

2.  By  the  unconscious  mind   influenced  directly 
by  surrounding  personalities   or   other  unconscious 
agencies  acting  as  suggestions. 

8.  By  the  unconscious  mind  influenced  indirectly 
by  the  conscious,  which  has  faith  in  persons,  systems, 
places,  &c. 

4.  By  the  unconscious  mind  indirectly  acted  on  by 


196  THE  FOECE  OF  MIND 

the  conscious  by  distinct  effort— in  determination  to 
get  well— to  shake  off  illness,  ignore  pain,  &c. 

I  have  spoken  a  little  of  Nos.  1  and  2,  and  I 
may  now  look  at  the  mind  acting  on  the  body  by 
faith-healing  and  kindred  agencies. 

A  recent  writer  in  the  '  British  Medical  Journal '  * 
reviews  these  as  follows  : 

Review  of          « We  Jive  in  an  age  in  which  there  is  not  only  a 

haJaiing.       survival  of  superstition  and  a  belief  in  the  occult  and  in 

quackery  of  all  descriptions,  but  in  an  age  in  which 

there  has  been  a  positive  revival  of  an  hysterical  form  of 

occultism,  a  jumble  of  pseudo-science  and  irreligion. 

'Faith-healing,  of  which  so-called  Christian  Science 
is  the  type,'-  is  a  money-making  concern,  and  a  diploma 
from  a  college  of  psychic  healing  can  be  obtained 
after  a  course  of  study  not  extending  beyond  three 
weeks,  in  some  circumstances  in  three  days. 

'  Medicine  and  religion  in  remote  times  grew  up 
side  by  side,  and  their  exposition  was  in  the  hands  of 
the  same  individual — the  priest-doctor;  a  belief  in 
the  occult  was  therefore  a  factor  in  each.  Even 
Hippocrates,  who  was  the  first  to  attempt  to  put 
medicine  on  an  improved  basis,  jumbled  fact  and 
fiction  and  fable  in  his  humoral  system  of  pathology. 
Every  physician  claimed  to  be  a  miracle-worker  in  a 
small  way  on  the  strength  of  cures  effected  through 
the  influence  of  the  mind  on  the  body ;  that  was,  by 
suggestion  and  expectant  attention.  .  .  .  The  morbid 
influence  of  occultism,  which  to  some  extent  declined 
in  the  time  of  Galen,  began  to  luxuriate  again  in 
the  Dark  Ages  in  association  with  alchemy,  astro- 

1  British  Medical  Journal,  1901. 

•  Christian  Science  is  not  the  type  of  faith-healing. 


VAEIETIES  OP  MENTAL  THERAPEUTICS    197 

logy,  necromancy,  and  religious  superstition.  Faith- 
healing,  touching  for  king's  evil,  mesmerism,  homoeo- 
pathy, and  clairvoyance  kept  occultism  going  from 
the  time  of  the  Stuarts  to  the  end  of  the  eighteenth 
century,  and  the  nineteenth  century  was  remarkable 
for  the  revival  of  the  belief  in  spiritualism,  mental 
telepathy,  and  "  divine  healing."  Quackery,  as  repre- 
sented by  fraudulent  institutes  for  the  deaf,  the  sale 
of  ear-drums,  and  of  panaceas  for  every  ailment 
under  heaven,  appeared  to  prosper  as  of  yore,  and 
would  continue  to  do  so  whilst  the  majority  of  man- 
kind were  unthinking  in  medical  matters,  and  unable 
to  throw  off  the  occultism  of  the  nursery.  Unfortu- 
nately, the  supporters  of  quackery,  Christian  Science, 
occultism,  and  all  forms  of  medical  heterodoxy  were 
found  as  often  in  the  castle  as  in  the  cottage.' 

Paracelsus  pointed  out  that,  '  whether  the  object  of 
your  faith  is  real  or  false,  you  will  nevertheless  obtain 
the  same  effects  ; '  thus  showing  that  the  virtue  is  not 
derived  objectively,  but  subjectively,  as  we  think, 
from  the  unconscious  mind. 

In  1651  we  read  the  following  sound  and  thought-  Faith  h«jf 
ful  remarks : l  '  All  the  world  knows  that  there  is  no 
virtue  in  charms,  &c.,  but  a  strong  conceit  and 
opinion  alone,  as  Pomponatius  holds,  which  forceth  a 
motion  of  the  humours,  spirits  and  blood,  which  takes 
away  the  cause  of  the  malady  from  the  parts  affected. 
The  like  we  may  say  of  the  magical  effects,  super- 
stitions, cures,  &c.,  such  as  are  done  by  mountebanks 
and  wizards.  As  by  wicked  incredulity  many  men 
are  hurt  (so  saith  Wierus),  we  find  in  our  experience 
by  the  same  means  many  are  relieved.' 
1  Burton,  Anatomy  of  Melancholy. 


198  THE  FOECE  OF  MIND 

Coming  down  to  our  own  times,  we  find  a  careful 
analysis  of  the  cause  of  faith-healing  as  follows : 
'  There  can  be  no  question  that  faith -healing  is  a  fact. 
The  brain  is  not  simply  the  organ  of  the  mind ;  it 
is  also  the  chief  centre,  or  series  of  centres,  of  the 
nervous  system,  by  which  the  whole  body  is  energised 
and  its  component  parts  with  their  several  functions 
NO  miracle  are  governed  and  regulated.  There  is  no  miracle  in 
hading*  healing  by  faith  ;  whereas  it  would  be  a  miracle  if, 
the  organism  being  as  it  is,  and  the  laws  of  life  such 
as  they  are,  faith-healing  did  not,  under  favourable 
conditions,  occur.'1  Here  conscious  mind  alone  is 
recognised  ;  the  unconscious  mind  being  '  a  series  of 
centres  '  endowed  with  psychical  powers  ! 

It  must  not  be  forgotten  that  function  goes  before 
organism  in  development,  and  that  there  are  large 
classes  of  cases  in  which  the  disabilities  of  the  diseased 
organ,  for  a  fair  performance  of   its   functions,  are 
mainly  due  to  a  want  of  power  or  regularity  in  action, 
it  is  the  .         There  is  a  large  body  of  trustworthy  evidence 
!S™B         ^iat   permanent    amendment,   of    a    kind    perfectly 
mind  that    obvious  to  others,  has  shown  itself  in  a  great  variety 
of  local  maladies,  when  the  patients  have  been  suffi- 
ciently possessed  by  the  expectation  of  benefit,  and 
by  faith  in  the  efficacy  of  the  means  employed. 

Observe  here  it  is  not  the  faith  itself  that  cures, 
but  faith,  fear,   &c.  set  into  activity  those  powers 
and  forces  that  the  unconscious  mind  possesses  over 
the  body,  both  to  cause  disease  and  to  cure  it. 
Binet  on  '  Those  who  undertake  miraculous  cures  ...  do 

no^  deny  the  existence  of  disease,  but  assert  that  it 
may  be  cured  by  supernatural  power.     They  act  by 

1  Editorial  in  Lancet,  June  13, 1885. 


VARIETIES  OF  MENTAL  THEEAPEUTICS    199 

means  of  suggestion  and  by  gradually  inculcating  the 
idea  that  the  disease  is  curable,  until  the  subject 
accepts  it.  The  cure  is  sometimes  effected  by  the 
suggestion,  and  when  it  is  said  to  be  by  saving. faith, 
the  expression  is  rigorously  scientific.  These  miracles 
should  no  longer  be  denied  ;  but  we  should  understand 
their  genesis,  and  learn  to  imitate  them.  These 
are  therefore  no  imaginary  diseases,  but  are  diseases 
due  to  the  imagination,1  and  accompanied  by  real 
functional  disturbances.  Such  disturbances  may  be 
developed  under  the  influence  of  spontaneous  (uncon- 
scious), accidental,  or  deliberate  (conscious)  suggestion, 
and  they  may  be  cured  under  the  influence  of  another 
suggestion  of  equal  intensity  working  in  an  inverse 
direction.  The  moral  treatment  ought  not  therefore 
to  consist  in  denying  the  existence  of  the  disease,  but 
in  asserting  that  it  is  susceptible  of  cure,  that  the  cure 
has  actually  begun,  and  will  soon  be  completed.' 2 

Following  in  the  same  line,  I  give  a  few  preg- 
nant remarks  of  Dr.  Clouston's.  He  says : 3  '  If  mind 
and  brain  so  powerfully  affect  the  conditions  of  dis- 
ease, one  naturally  turns  to  them  in  looking  for 
means  of  cure.  And  beyond  all  question  we  can 
often  get  effectual  help  there.  Half  the  diseases  that 
kill,  as  I  have  already  said,  do  so  because  there  is  no 
sufficient  power  in  the  organism  to  resist  them.  The 
physiological  commonly  passes  into  the  pathological, 
because  the  nerve  energy  is  below  par.  To  check 
many  diseased  conditions  we  cannot  employ  better 

1  Here  we  get  the  distinction  between  these  two  insisted  on 
which  I  have  pointed  out  in  earlier  chapters. 

1  Binet,  Animal  Magnetism  (International  Science  Series), 
p.  354. 

1  Dr.  Clouston,  British  Medical  Journal,  January  18, 1891. 


200  THE  FOECE  OF  MIND 

therapeutics  than  to  stimulate  the  cortex  and 
strengthen  the  mental  energy.  To  this  end  the  first 
thing  a  good  doctor  does  is  to  inspire  confidence  in 
his  patient.  What  is  this  but  a  bit  of  psycho-thera- 
peutics? And  it  is  an  all-important  one  in  many 
cases.  So  to  condition  the  patient  that  his  brain  and 
mind  are  kept  up  to  the  very  highest  mark  attainable, 
to  remove  irritations  (mental  and  nervous),  and  to 
distract  attention  from  a  lowering  to  a  cheerful  view 
of  the  whole  situation,  may  make  all  the  difference 
between  life  and  death  in  many  a  case.  Hope  and  a 
calm  cheerfulness  are  often  the  best  general  aids  to 
healthy  metabolism.  We  know  that  a  joyful  emotion 
will  at  once  fill  the  cortical  capillaries.  It  is  a  true 
cerebral  stimulant.  Aided  by  medicinal  cortical 
tonics  and  stimulants,  like  strychnine,  quinine,  the 
mineral  acids,  &c.,  mental  stimulation  is  an  undeniable 
adjuvant  to  the  local  treatment  of  disease,  and  is 
used  largely  by  the  most  successful  physicians.' 

Bearing  this  in  mind,  we  can  better  understand 
the  following  from  '  The  Lancet : ' 

^irtto  '  ^  ma^a^v  m<iuced  by  mental  reflex  can  only  be 

vahieCof      cured  by  mental  remedy.     A  full  recognition  of  the 

hop«n!i*ui  value  rightly  attaching  to  the  mental  treatment  of 

onr^xt-     physical  ailments  will  improve  the  usefulness  of  the 

physician  and  materially  assist  in  the  recovery  of 

his  patients.     In  disease,  functional  or  organic,  the 

therapeutic  value  of  faith  and  hope,  though  not  in  our 

text-books,  is  often  enough  to  turn  the  scale  in  favour 

of  recovery.' ' 

Dr.  A.  T.  Myers  says :  '  In  examining  a  patient  in 
a  modern  hospital  we  rely  on  observable  and  measur- 

1  Editorial,  Lancet,  1883,  i.  19. 


VARIETIES  OF  MENTAL  THEEAPEUTIC8   201 

able  facts,  less  on  the  patient's  own  statements  of 
what  he  feels,  least  of  all  on  his  theories  how  he  came 
to  feel  it.  In  doctoring  him  we  rely  much  on>  definite 
operations  and  on  those  few  drugs  whose  action  on 
the  body  we  can  prove,  little  on  the  patient's  prayers 
for  recovery,  least  of  all  perhaps  on  the  encouraging 
words  we  throw  in.  Yet  cures  have  always  been 
effected  by  other  than  physical  means.  Either  these 
can  be  referred  to  physiological  means  which  have 
escaped  detecting,  or  they  cannot.' 

In  connection  with  prayer,  we  may  here  note  that 
'  prayer-healing '  has  for  some  time  prevailed  in 
aristocratic  circles  in  Berlin  and  Potsdam ;  and  a 
pharmacopoeia  of  prayers  to  be  used  against  special 
forms  of  disease  has  been  prepared.  In  America,  and 
even  in  England,  'prayer-healers'  are  found,  who 
have  a  moderate  scale  of  charges  for  their  services. 
The  whole  idea  to  me  seems  irreverent  and  revolting. 

Dr.  Carpenter  says :  ' "  That  the  confident  expec- 
tation of  a  cure  is  the  most  potent  means  of  bringing 
it  about,  doing  that  which  no  medical  treatment  can 
accomplish"  may  be  affirmed  as  the  generalised  result 
of  experiences  of  the  most  varied  kind  extending 
through  a  long  series  of  ages.' 

We  find  in  '  The  Lancet '  again  the  following : 1 

1  We  will  even  go  so  far  as  to  affirm  that  a  very 
large  proportion  of  the  ailing  might  be  and  probably 
would  be  sound,  if  only  they  were  sufficiently  strongly 
impressed  to  believe  themselves  so.  The  influence  of 
the  mind  '  (here  observe  in  the  same  journal  the  'nerve 
centres'  of  1885— see  page  198— are  boldly  called 
'  the  mind '  in  1888)  '  upon  the  body  has  been  the 

1  Lancet,  February  28, 1888. 


202  THE  FOECE  OF  MIND 

stronghold  of  quackery  from  the  earliest  times ;  and 

faith  is  as  powerful  an  influence  for  good  or  evil  now 

as  it  has  ever  been.' 

Eight  Faith  cures  exist  of  many  varieties. 

faUh  cum!        !•  There  is  the  prayer  and  faith  cure  at  Lourdes ; 

which  is  based  upon  faith  in  God  and    the  Virgin, 

perhaps  mostly  on  the  latter. 

2.  Eelic  cures  of  all  sorts ;   where  the    basis   is 
faith  in  the  holy  emblems,  seen  or  touched. 

3.  Evangelical  faith  cures ;   based  upon  external 
Divine  power. 

4.  Mind  cures  ;   effected  by  the  realisation  of  the 
power  of  mind  over  matter,  or  by  the  conscious  effect 
of  the  mind  of  the  healer  on  the  patient. 

5.  Christian  Science  cures  ;  based  on  the  unreality 
of  disease,  and  the  direction  of  the  mind  to  the  Divine. 

6.  Spiritualistic  cures ;  effected  by  faith  in  departed 
spirits. 

7.  Mesmeric  cures  ;   effected  by  a  supposed  fluid 
or  magnetic  influence  passing  from  healer  to  patient. 

8.  Direct  faith-healing ;  effected  by  faith-healers, 
in  whom  the  patient  has  confidence  and  who  heal  on 
the  spot. 

CT^h"  b  Those  ignorant  of  the  power  of  the  mind  over  the 

d^eitnor    body  see  nothing  in  cures  effected  by  such  agencies 

but  either  deceit  or  miracle— whereas  the  powers  of 

the  unconscious  mind  explain  them  all.     Faith  itself 

is  healthful.     Sir  J.  C.  Browne  at  Leeds  said :  '  The 

normal  action  of  faith  is  wholesome  and  hygienic.' 

Christian  I  may  perhaps  take  this  opportunity  of  saying  a 

acts  by       little  more  about  Christian  Science  in  view  of  its  rapid 

^tTon/*"    development  in  the  teeth  of  its  extraordinary  doctrines. 

My  remarks  here  are  of  course  solely  directed  to  its 


VAEIETIES  OF  MENTAL  THERAPEUTICS    203 

scientific  position  as  a  curative  agent :  of  its  relation 
to  Christianity  I  prefer  not  to  speak  in  detail ;  indeed, 
to  do  so  would  be  outside  the  scope  of  this  work. 

Christian  Science,  then,  cures  by  a  process  of  auto- 
suggestion. Instead  of,  as  in  hypnotism  (of  which 
more),  suggestions  being  always  made  by  the  hypno- 
tiser,  they  are  sometimes  made  by  the  teacher  to  the 
faithless  and  the  neophytes,  but  adepts  are  taught  to 
make  them  to  themselves. 

Christian  Science  thus  occupies  a  platform  alto-  Christian 
gether  distinct  from  every  species  of  mind  or  faith  distinct 
healing,  hypnotism,  or  suggestive  cures,  and  claims 
therefore  these  few  explanatory  lines.    In  the  first 
place,  it  is  no  more  a  mere  therapeutical  society 
than  vegetarians   are  a    body  of    people  who    eat 
vegetables,  as  is  vulgarly  supposed.    As  a  matter  of 
fact,  most  vegetarians   consume  large  quantities  of 
animal  food  daily,  in  the  shape  of  eggs,  milk,  &c.,  and 
may  be  best  described  as  strong  religious  zoophilists. 

In  the  same  way,  while  in  Christian  Science  the 
cures  most  arrest  the  attention  of  the  careless,  they  a  system  oi 
are  but  the  outward  signs  of  an  inward  system  physic*, 
of  metaphysics,  which,  while  professedly  based  upon 
the  Bible,  gives  such  an  artificial  and  special  force  to 
the  words  it  quotes  as  to  entirely  alter  their  meaning. 
This,  in  default  of  a  dictionary,  makes  its  teaching  a 
little  difficult  to  follow.  Christian  Scientists  argue 
from  the  fact  of  God  being  all-good  and  all-present, 
that  there  can  be  nothing  evil,  as  there  is  no  room  for 
it  in  God's  universe;  sin,  disease,  and  death  being 
specially  creations  of  a  distorted  mind.  Hence,  when 
one  has  grasped  this  spiritual  truth  (?),  the  supposed 
disease  is  clearly  seen  to  be  a  delusion,  equally  with 


204  THE  FOKCE  OP  MIND 

the  body  itself,  where  it  was  falsely  supposed  to  occii/. 

A  mystic     The  system,  in  short,  is  a  mystic  Theism,  the  ordinary 

iam'      tenets  of  Christianity,  as  distinct  from  this,  being  not 

exactly  denied,  but  explained  in  a  way  that  robs  them 

of  all  their  accepted  meaning. 

The  cures   are  many  of  them  undeniable,  and 

mainly  functional,  though  I  have  known  one  case  of 

varicose  veins  cured,  and  of  course  more  remarkable 

The  curft-     results  are  claimed.     I  do  not  see  why  in  these  cures 

tattie8'*™!-   we  nee^  l°°k  further  for  an  efficient  cause  than  to  the 

consciong     power  of  the  mind  (that  is,  the  unconscious  mind)  over 

the  body ;  and  that  this  is  not  limited  to  function,  we 

have  had  ample  proof.     The  fact  is  that,  setting  aside 

for  a  moment  cures  attributed  to  drugs  and  ordinary 

medical  treatment,  that  system  will  undoubtedly  show 

most  cures   that  can   best   command  the  beneficial 

influence  of  the  mind  over  the  body;  and  it  would 

seem  that  a  system  that  asserts  there  is  only  mind, 

and  that  disease  does  not  exist,  reaches  this  end  by 

the  shortest  road.     With  those  who  find  themselves 

able  to  accept  its  doctrines  the  method  is  more  than 

Cnreby      suggestion;  it  is  dogmatic  assertion,  something  like 

action     that '  force  of  assertion  '  Sir  James  Paget  speaks  of 

in  his  letter  quoted  in  Chapter  I.,  and  to  which  he 

attributes  such  power.     It  is  apparently  based  upon 

a  reasonable  axiom,  and  supported  by  the  highest 

spiritual  claims  ;  and  where  its  influence  is  yielded  to, 

whatever  beneficial  power  over  disease  the  mind  does 

possess  is  necessarily  brought  into  play. 

Though,  therefore,  the  philosophy  of  the  cure  differs 
in  toto  from  all  forms  of  faith-healing,  inasmuch  as 
the  results  are  similar,  and  the  limits  of  the  power  of 
the  mind  over  the  body  are  as  yet  unknown,  there  is 


VAEIETIES  OF  MENTAL  THEEAPEUTICS   205 

no  need  to  seek  for  a  further  cause,  even  in  cases  of 
organic  cure. 

And  now  for  one  word  on  hypnotism.    It  will  be 
observed  that  all   the  above  varieties  of  faith  and    sm 
mind  cures  reach  the  unconscious  mind,  and  through 
it  the  body,  by  way  of  consciousness  and  intelligence. 
The  latter  may  not  be  of  a  very  high  order,  it  is  reveals 
true,  but  all  that  there  is  is  used,  while  consciousness  consdoua 
is  fully  active ;  so  that  they  contrast   sharply  with  mind'1 
hypnotism,  where  the  conscious  mind  is  put  to  sleep, 
and    the   unconscious  powers,   usually  hidden,   are 
exposed  and  brought  to  the  front,  so  as  to  be  directly 
reached  by  suggestions. 

It  is  obvious  that  hypnotism  is  of  most  value  to 
those  to  whom  no  variety  of  faith  cure  appeals ;  either 
from  too  little  emotion  or  too  much  intellect,  both  of 
which  often  are  stumbling-blocks  hi  the  way  of 
success. 

Where  faith  cures  are  available,  they  are,  I  think,  Faith  cure* 
preferable  to  hypnotism ;  and  I  believe  Ernest  Hart,  vh^T 
the  late  editor  of  the  '  British  Medical  Journal,'  who  aTailable- 
closely  investigated  some   of    the  wonders    at  the 
Salpetriere,  expressed  the  same  opinion. 

We  cannot  of  course,  however,  force  ourselves  to 
believe  ;  and  it  is  often  difficult  by  ordinary  means  to 
set  in  train  the  curative  powers  of  the  unconscious 
mind. 

It  is  owing  to  this  lack  of  power  that  hypnotism 
has  arisen,  and  undoubtedly  supplies  a  greater  force  th 
and  a  therapeutic  agent  fraught  with  larger  powers  ; 
which,  like  all  potent  remedies,  sometimes  acts  as  a 
poison.  Wherein,  then,  does  its  power  lie  ?  As  far  as  I 
can  ascertain,  in  this  simple  fact,  which  I  beg  may  be 


206  THE  FOECE  OF  MIND 

noted :  consciousness  is  in  abeyance,  and  the  un- 
conscious mind  is  placed  in  a  condition  to  be  directly 
influenced  by  the  hypnotist,  in  a  way  that  is  not 
possible  by  any  other  means. 

The  powers        The  powers  of  the  'unconscious  mind'  thus  re- 
of  the  on-    yealed  are  truly  marvellous  both  mentally  and  phy- 
mind         sically.     Mentally  it  can  recall  facts,  dates,  numbers, 
&c.  in  a  way  far  beyond  the  powers  of  the  individual. 
I    came    across    an    instance    this    year  worth 
recording  here.     A  young  lady  of  nineteen  was  placed 
under  hypnotic  treatment  by  a  physician  for  violent 
muscular  tremors  of  all  the  limbs — constant  diffused 
headache — attacks  of  pain  over  the  heart — faintness 
— dysmenorrhoea — obstinate  constipation  and  other 
symptoms.      After  the  failure  of  ordinary  means, 
suggestive  and  otherwise,  the  patient  was  hypnotised 
eleven  times   in  all — cured,  and  returned  to  work. 
Ca*e  Ot        Opportunity  was,  however,  taken  to  test  her  mental 
»bu>  powers  hi  the  hypnotic  state,  and   on  Wednesday, 

memory.  ^farcn  j^  ^  4  P>M>  sne  was  hypnotised  in  the 
presence  of  three  medical  men,  and  four  suggestions 
were  made  that  the  patient  should,  after  the  expiration 
of  the  number  of  minutes  they  named,  make  a  cross 
on  a  piece  of  paper.  These  numbers  were  21,400, 
21,420,  21,428,  21,434  minutes.  On  the  right  day, 
Thursday,  March  26,  the  lady  was  hypnotised,  and 
made  the  four  crosses  spontaneously  without  sug- 
gestion ;  two  of  them  at  the  exact  minute,  one  a 
minute,  and  the  other  two  minutes,  too  soon. 

•Dr>  Milne  Bramwell,  who  was  present  at   this 
experiment,  records  also  the  following : '  '  I  accidentally 

1  Dr.  Milne  Bramwell, '  Hypnotic  and  Post-Hypnotic  Appreciation 
of  Time,'  Brain,  1900. 


VAEIETIES  OF  MENTAL  THEEAPEUTICS    207 

discovered  that  deep  hypnosis  was  associated  with  an 
increased  appreciation  of  time.  The  following  were 
the  usual  suggestions  given:  (1)  A  simple  act  was 
suggested  during  hypnosis  which  was  to  be  carried 
out  at  a  given  time  before  that  state  terminated. 

(2)  The  subject  was  told  during  hypnosis  that  this 
state  was  to  terminate  at  a  specified  future  hour. 

(3)  The  performance  of  a  simple  act  at  a  given  hour 
after   the   termination    of    hypnosis  was   suggested. 

(4)  Awakening  from  natural  sleep  at  a  given  hour  was 
suggested  during  hypnosis.     (5)  The  subject  was  told 
in  the  waking  state  that  he  was  to  pass  into  the 
hypnotic  condition  at  a  given  hour,  remain  hypnotised 
for  a  specified  length  of  time,  and  perform  certain 
simple  acts  at  stated  intervals ;  then  pass  again  into 
the  normal  state  and  remain  in  it  for  a  specified 
time,  and  again  pass  into  the  hypnotic  condition. 
These  experiments,  continued  from  1889  to  the  present 
date  (1902),  have  been  frequently  repeated   before 
competent  observers.     The  majority  of  the  sugges- 
tions were  executed  at  the  moment  indicated,  while  in 
the  remainder  the  error  in  time  appreciation  rarely 
exceeded  five  minutes.' 

The  appreciation  of  time  possessed  by  the  un- 
conscious  mind  does  not  always  require  hypnotism 
for  its  demonstration.  Many  people  can  set  their 
minds  at  night  to  call  them  in  the  morning.  The 
following  is  an  authentic  instance,  and  the  writer  of 
this  is  another. 

Dr.  George  Savage  possesses  the  power  of  waking 
at  a  given  hour,  and  has  tested  it  on  many  occasions. 
The  following  is  an  example:  One  day,  having  to 
catch  an  early  train,  he  determined  to  wake  at  6  A.M., 

p 


208  THE  FOBCE  OF  MIND 

and  slept  soundly  without  waking  until  the  exact  time. 
The  seven  following  mornings  he  woke  exactly  at 
six,  notwithstanding  that  he  went  to  bed  at  different 
hours,  and  there  was  no  necessity  for  early  rising. 
This  involuntary  repetition  of  self-waking  at  unusual 
times  also  occurred  when  he  was  roused  by  others 
at  abnormally  early  hours.  Thus,  when  in  the 
Alps,  if  he  were  called  at  2  or  3  A.M.  he  would  cer- 
tainly wake  spontaneously  at  the  same  hour  next 
morning,  even  if  he  had  been  much  fatigued  with 
climbing.  Dr.  Savage  states  that  the  accuracy  of  the 
time  of  waking  in  these  instances  has  puzzled  him 
greatly. 

secondary          Into  the  question  of  the  secondary  consciousness 
J^.cl°l       of  the  '  unconscious  mind  '  I  cannot  now  enter.     It 
would  not  alter  our  designation,  for '  unconscious '  here 
only  refers  to  its  relation  with  ordinary  consciousness, 
which  is  the  only  consciousness  possible  to  consider 
in  these  pages.     The  side  issues  connected  with  the 
force  of  mind  are  so  interesting  in  themselves,  that 
one  is  ever  tempted  to  follow  them.     In  this  case 
A  Bimpie     Dr.  Hyslop's  explanation  of  double  consciousness  is 
tk>nlan*      perhaps  the  best,1  though  hardly  intelligible  to  lay 
readers  ;  for,  to  put  it  simply,  we  may  say  he  regards  it 
as  due  to  a  supposed  inhibition  of  the  amoeboid  move- 
ments in  the  pseudopodic  protoplasmic  prolongations 
of  the  neurospongium  ! 
Hypnotism        In  the  body,  hypnotism  reveals  equally  marvellous 

produces  .      ,      '  .  .  _f  , 

physical      powers  of  the  unconscious  mind.     It  can  be  made  to 
manir        produce  at  will  blisters,  swellings,  erythemas,  pain 

or  ease,  paresis,  temperatures,  and  other   physical 

phenomena. 

1  Dr.  Hyslop,  British  Medical  Journal,  September  1899. 


VAEIETIES  OF  MENTAL  THERAPEUTICS    209 

In  both  mesmerism  and  hypnotism  it  has  been  a 
question  whether  the  results  were  due  to  a  force 
proceeding  from  the  healer's  mind  or  the  arousing  of 
a  latent  force  in  the  patient's  mind.  It  is  now 
practically  decided  that  both  contribute;  but  the 
force  is  mainly  from  the  latter  source. 

Before  closing  this  chapter  we  may  look  at  some 
mental  qualities  that  are  recognised  as  curative  agents. 

Sir  John  Forbes  gives  as  psychic  powers  of  cure : 
augmented  hope  —  faith  —  cheerfulness  —  mental 
activity — decreased  anxiety — mental  work— new  mo- 
tives for  mental  action — new  motives  for  physical 
life — soothing  moral  and  religious  sensibilities. 

'Imagination,1  says  Sir  J.  C.  Browne,1  'is  one 
of  the  most  effectual  of  psychical  agencies  by  which 
we  may  modify  the  conditions  of  health  and  disease.' 
A  disciplined  imagination  is  one  of  the  most  valued 
tools  of  a  physician. 

A  strong  will  is  a  good  therapeutic  agent.  Mental 
therapeutics  may  be  directed  to  calming  the  mind  in 
excitement,  arousing  feelings  of  joy,  hope,  faith,  and 
love  ;  by  suggesting  motives  for  exertion,  by  inducing 
regular  mental  work,  especially  composition,  by 
giving  the  most  favourable  prognosis  possible,  by 
diverting  the  thoughts  from  the  malady. 

Sympathy,  religion,  common  sense,  patience,  in- 
difference, neglect,  altruism,  philanthropy,  ambition, 
are  all  at  times  good  mental  medicines. 

The  doctor  himself,  his  illegible  prescription,  his 
room,  and  even  his  fee  (if  impressive),  are  all  valuable  biii  u  » 
therapeutic  agents. 

1  Sir  J.  C.  Browne,  Leeds,  1889. 


210  THE  FOBCE  OP  MIND 

De  Fleury  says:  'In   describing   the  action  of 

a  remedy,  the  doctor  of  to-day — the  incorrigible  of 

Moliere's  comedy — instinctively  resorts  to  big  words 

as  a  dwarf  to  high  heels.'     No  doubt  these  big  words 

have  also  much  value,  though  they  may  have  little 

meaning.     Have  we  not  all  heard  of  the  soothing 

power  of  '  that  blessed  word  Mesopotamia '  ? 

Th«  But  the  doctor's  face  is  worth  more  than  his 

f^aJnd      words,  and  no  doctor  ever  knows  how  keenly  it  is 

long  words.  8tll(iied.     It  would  be  well  worth  while  to  write  a 

book  on  the   medical    face — 1st,   as    seen    in    the 

patient  as  a  diagnostic  sign  of  physical  and  mental 

disease ;  and,  2nd,  as  seen  on  the  doctor  as  a  power 

for  good  or  evil. 

Fear  u  a          Fear  is  itself  a  great  therapeutic  agent,  but  is,  like 

pe^         the  salts  of  copper  and  other  poisonous  drugs,  too 

*gent         dangerous  for  general  use  by  medical  men.     Still  in 

some  cases  fear  in  small  doses  acts  as  a  sort  of  mental 

digitalis. 

One  golden  rule  of  mental  therapeutics  must  not  be 
forgotten — that  the  cure  of  sick  or  exhausted  nerves 
must  precede  the  cure  of  a  sick  mind.  The  implant- 
ing of  therapeutic  ideas  is  only  possible  successfully 
in  a  healthy  soil. 

o«cia-  I  close  with  a  restatement  of  the  thesis  of  this 

chapter,  that '  the  effective  agent  in  all  faith  cures  is 
the  unconscious  mind.' 


CHAPTER  Xn 

ILLUSTRATIONS  OF  THE  CURATIVE  POWBB 
OF  MIND 

'  The  force  of  mind  is  a  therapeutic  agent  in  every 
disease.' 

BEFORE  giving  a  few  illustrations  of  the  power  of  the  Th«  T^ 
mental  factor  as  a  medicine  in  ordinary  diseases,  °<dn1*1- 
I  will  say  a  word  or  two  about  drugs. 

Perhaps  nowhere  has  the    misleading    doctrine 
of  post  hoc  ergo  propter  Jioc  been  more  mischievously 
used  than   in  pharmacy.     The  power  of  drugs  as  Sponu 
compared  with    the    power  of    the  vis  medieatrix  *uudM' 
natures  is  as  spurs  when  compared  with  the  muscles 
of  a  horse,  which,  after  all,  are  the  moving  power. 

But  there  is  this  difference.  Spurs  always  mean 
greater  effort  on  the  horse's  part,  and  no  horse  re- 
gards them  as  a  signal  to  stop.  But  with  drugs,  even 
of  a  powerful  nature,  the  action  often  depends  upon 
the  mind,  which  can  increase,  neutralise,  and  even 
reverse  their  action  to  an  almost  incredible  degree. 
An  example  or  two  will  suffice. 

A    colleague   of    mine    recently  gave  a  woman  B«M*«I 
some  opium  pills  to  produce  sleep,  but  forgot  to  tell  SZS 
her  their  object.     The  next  week  she  told  him  the  ™ad- 
pills  had  opened  the  bowels  well  each  morning,  but 


212  THE  FOECE  OF  MIND 

had  griped  her  a  little.     On  inquiry  he  found  that  she 
had  had  no  better  sleep. 

Another  woman  thought  she  had  taken  a  large 
dose  of  rhubarb  as  a  remedy  for  constipation,  and 
soon  had  five  or  six  movements  of  the  bowels.  She 
discovered  afterwards  that  she  had  forgotten  to  take 
the  medicine. 

The  effects  of  a  purgative  pill  have  been  rendered 
nil,  and  it  has  produced  sleep  in  the  belief  that 
it  was  an  opiate  pill,  though  consisting  of  a  strong 
dose  of  colocynth  and  calomel. 

physical  All  drugs,  or  rather  compounded  medicines,  have  a 

dta  Mtion   twofold  value— one  physical,  and  the  other  psychical. 

of  drugs.  gir  g_  Wilkg  thinkg  mogt  Qf   the  latter_       <  J  do  not 

say,'  he  observes,   '  that  drugs  are  not  useful  in  a 
moral  sense.' 

Sir  W.  Gull's   prescriptions  frequently  consisted 
of  saccJi.  ust.     His  followers  are  legion — all  of  them 
regular  practitioners,  who  scorn  '  quackery  ' ! 
Physical  The   increasing   disbelief   in   the   physical   value 

tojcaiy8io"  °*  drugs  has  led  to  a  great  growth  of  physical  and 
remedies,     physiological  remedies  as  opposed  to  pharmacy ;  and 
these  physical  agencies  are  greatly  to  be  preferred  to 
pure  expectation  or  nihilism,  to  which  at  one  time  the 
physician  was  wellnigh  reduced. 

Turning  to  the  psychical  value  of  drugs,  in  1771 
Unzer  remarked  :  '  The  expectation  of  the  action  of  a 
remedy  often  causes  us  to  experience  its  operation 
beforehand.'  New  remedies  have  thus  a  greater  effect 
when  first  introduced  than  afterwards. 

Reputation  It  is  extraordinary  how  little  the  disturbing  in- 
SfocSfa  fluence  of  the  mind  on  the  action  of  drugs,  of  which 
vaiu*.  i  have  given  some  instances,  is  taken  account  of  by 


THE  CUEATIVE  POWEE  OF  MIND      213 

the  average  physician.  So  great  is  it,  that  the  test- 
ing of  new  drugs  must  be  done  secretly,  or  the  results 
will  be  vitiated  by  the  mental  action  of  the  patient. 
Many  of  the  difficulties  and  uncertainties  of  pharmacy 
really  arise  from  this  mental  factor. 

As  long  as  a  medicine  is  powerful  in  psychic  qualities 
it  cures  readily  ;  when  it  falls  into  disrepute  or  out  of 
fashion,  and  the  halo  goes,  it  loses  much  of  its  value. 

Moreover,  as  the  supposed  rational  action  of  drugs  Use  of 
breaks  down  under  modern  searching  investigation,  becoming 
their  use  becomes  more  and  more  empirical.  e^ricai 

Still,  certain  drugs  triumphantly  assert  their 
physical  powers  in  spite  of  latter-day  scepticism.  No 
mind  force  is  on  a  par  for  certainty  of  action  with 
mag.  sulph.,  pulv.  jalapae,  croton  oil,  or  apomorphia. 

In  serious  organic  diseases  the  power  of  the  mind 
can  do  little,  but  then  it  is  also  true  that  drugs 
at  such  a  time  can  do  even  less. 

We  must  not  underrate  the  role  which  careful 
therapeutics  may  play  in  building  up  the  system  ; 
but  it  may  all  fail  when  there  is  some  mental  draw- 
back, which  a  little  judicious  advice  might  remove 
and  change  the  whole  situation.  Dr.  Bennett  points  ine£ 
out  that  many  drugs  and  systems  of  treatment  are 
(pharmaceutically)  inert  or  uncertain  in  their  action, 
though  supposed  to  act  through  the  blood ;  whereas 
in  fact  their  successful  operation  is  due  to  exciting 
expectant  ideas,  and  through  these  (by  the  uncon- 
scious mind)  acting  indirectly  on  the  disordered 
parts. 

I  will  now  pass  on  to  instances  of  the  curative 

power  of  mind. 

Sir  Thomas   Grainger  Stewart  says:    'In  heart 


214  THE  FORCE  OP  MIND 

disease  the  most  important  element  is  rest.  Second 
in  importance  is  perhaps  the  element  of  hope.  If  a 
patient  becomes  persuaded  that  he  may  recover,  that 
good  compensation  may  be  established,  he  becomes 
more  hopeful  about  himself  and  his  heart  benefits 
correspondingly.  If  a  patient  is  gloomy  and  de- 
spondent, this  damages  the  organ  in  a  way  we  cannot 
at  present  fully  explain.' 

cnre  of  '  A  lady  suffered  from  organic  heart  disease  and 

dUmM  by  rapidly  developed  dropsy,  from  distress  at  the  mis- 
conduct of  her  husband,  and  was  in  imminent  peril 
of  death.  At  this  crisis  she  lost  her  reason.  The 
disturbing  mental  factor  (of  disease)  being  eliminated, 
the  balance  of  the  labouring  circulation  quickly  righted 
itself,  but  the  reason  was  not  restored.' *  This  is 
a  very  remarkable  proof  of  the  mental  factor.  Even 
where  the  mind  does  not  cure,  it  often  greatly  relieves. 
Tue  mind  Anaesthesia  is  common  with  melancholies,  hyper - 
sesthesia  with  neurotics.  Insensibility  and  pain  are 
common  in  mental  disease. 

Soldiers  in  victory  remain  practically  insensible 
to  cold.  Hunger  and  thirst  are  modified  by  the  con- 
dition of  the  mind.  Thirst  is  often  removed  by 
attention  being  diverted.  On  the  other  hand,  it  is 
very  common  among  soldiers  at  the  beginning  of  a 
battle.  Soldiers  in  battle  seldom  feel  any  pain  in  the 
wounds  until  the  battle  is  over.  Carpenter  says,  and 
the  writer  can  bear  most  emphatic  testimony  to  the 
same  fact,  that  he  has  often  found  in  speaking,  when 
suffering  from  severe  rheumatic  pain,  that  it  has 
entirely  ceased  to  be  perceived  until  he  sat  down, 
when  it  returned  in  full  force. 

1  Dr.  A.  Morrison.  Practitioner,  1892,  p.  29. 


THE  CURATIVE  POWER  OF  MIND       215 

Pains,  it  is  well  known,  go  when  the  doctor  comes, 
and  toothache  ceases  in  the  dentist's  room. 

Professor  A.  Ford  says  :  '  During  the  summer  of  Cure  of 
1891  I  met  an  attendant  K.  from  Wiirtemberg  while  h< 
I  was  lecturing  at  Zurich,  who  had  constant  head- 
aches for  two  years  after  a  severe  pneumonia.  The 
physician  there  told  him  these  headaches  would  never 
leave  him,  as  they  were  an  inheritance  from  his 
father  ;  and  he  had  never  lost  them,  always  feeling  a 
dull  pressure  on  the  head.  This  showed  the  two 
years'  headache  was  nothing  else  than  the  result  of 
an  unconscious  suggestion  of  the  physician.  The 
man  had  only  had  the  most  temporary  headaches 
before.  I  then  told  him  definitely  that  headaches 
were  not  an  inheritance,  and  could  easily  be  cured. 
Since  then  (four  months)  the  chronic  headache  has 
disappeared.  'This  case,'  he  continues,  'seems  to 
be  very  instructive,  because  it  shows  how  easily 
physicians,  without  knowing  it,  can  produce  sickness 
by  pessimistic  prophecies,  by  anxious  looks  or  words. 
Thus  are  diseases  suggested  (unconsciously)  by  the 
physician !  ' l 

'  I  myself,'  he  says,  '  committed  the  same  fault. 
A  female  attended  me  with  pains  in  the  stomach.  I 
diagnosed  and  treated  her  anxiously  for  gastric  ulcer. 
For  months  she  kept  her  bed,  and  gradually  recovered 
with  the  stomach  very  sensitive  for  years.  I  have 
not  now  the  slightest  doubt  that  her  long  sickness 
was  produced  by  over-anxious  investigations  and 
strict  regimen.' 2 

1  Professor  A.  Ford,  American  Journal  of  Psychology,  iv.  4. 
«  Ibid. 


216  THE  FOECE  OF  MIND 

I  think  many  physicians  as  they  read  this  will 
search  their  own  memories,  and  find  recorded  there 
more  than  one  parallel  case. 

Them-  I  will  now  give  an  instance  of  the  value  of  a  new 

^wer  of      curative  agent  from  my  own  experience. 

the  dock;  j  refer  to  the  therapeutic  value  of  a  striking 
mantelpiece  clock.  (I  say  clock  in  preference  to 
watch,  because  it  has  a  greater  value ;  and  I  say 
mantelpiece  instead  of  hall  clock  for  the  same  reason ; 
and  I  add  striking  as  being  of  still  greater  efficacy.) 
Sir  Dyce  Duckworth,  without  dwelling  on  the  value  of 
mental  therapeutics,  has  pointed  out  its  use  by  means 
of  the  clock,  in  showing  the  great  effect  in  cases  of  per- 
sistent vomiting  in  giving  the  liquid  food  in  teaspoon- 
fuls  every  five  minutes  by  the  clock.  If  the  patient  is 
told  that  the  food  thus  given  will  be  retained,  and  if 
he  can  see  the  clock  clearly  from  the  bed,  it  will 
probably  be  successful ;  for  at  the  exact  time  the  un- 
conscious mind  enables  the  stomach — probably  by 
some  inhibitory  power  over  the  vomiting  centre  in  the 
medulla — to  retain  the  food. 

ubo'S118  Some  years  ago  I  tested  the  value  of  the  clock  in 

labour  in  200  uncomplicated  cases.  In  cases  where  the 
uterine  contraction  was  very  irregular  and  slow,  I 
discovered,  by  impressing  the  patient  with  the  fact 
that  a  contraction  would  and  must  begin  every  five 
minutes  by  the  watch  and  last  two  minutes,  giving  three 
minutes'  interval,  that,  after  a  little  assistance  at  first,  I 
could  ensure  in  the  case  of  a  patient  of  average  mental 
power  a  contraction  commencing  exactly  when  I  said 
the  time  was  up.  I  calculated,  of  course  roughly, 
that  my  attendance  at  the  100  cases  treated  thus 
with  suggestion  was  shortened  an  average  of  two 


THE  CUEATIVE  POWEE  OF  MIND       217 

hours  each,  as  compared  with  the  100  left  entirely  to 
nature.  Of  course  it  is  obvious  this  calculation  is 
not  exact,  but  the  fact  of  the  value  and  power  of 
unconscious  mental  action  or  suggestion  is  clearly 
evidenced.  This  induced  action  by  means  of  the 
patient's  own  unconscious  mind  must  be  carefully 
distinguished  from  the  physical  force  or  mechanical 
aid  often  used  so  disastrously.  The  one  is,  in 
a  sense,  natural,  the  latter  purely  artificial.  I  think 
any  medical  man  who,  in  suitable  cases,  gives  this 
plan  a  fair  trial,  will  be  much  pleased  with  the 
results. 

In  the  nursery,  again,  the  clock  is  a  very  founda-  &»  *• 
tion  of  health.  Food  given  by  it  agrees,  without  it 
disagrees.  Sleep  regulated  by  it  is  easily  obtained, 
irregular  bedtimes  are  bad.  Its  value,  also,  is  that  it 
tends  to  produce  habits  of  the  utmogt  benefit  to  the 
young  child.  I  will  now  give  one  instance  of  its  power 
in  old  age. 

A  patient  about  seventy  years  of  age  came  to  me  j£8tina 
in  deep  distress  about  her  obstinate  constipation  from  constip*- 
paresis  of  the  rectum,  which  was  so  severe  that  every  tion' 
enema  and  pill  had  failed,  and  mechanical  evacuation 
was  the  last  resource.     This  condition  had  continued 
for  some  years,  a  trained  nurse  living  in  the  house. 
The  patient  was  of  exceptionally  powerful  mind  and 
will,  and  remarkable  intellect.     Seeing  this,  I  relied 
upon  the  clock  as  an  efficacious  aperient.     I  explained 
the  power  of  an  exact  habit  over  the  bowels,  and  told 
her  she  would  be  cured  if  at  9.80  exactly  by  the  clock 
on  the  mantelpiece  she  sought  relief  each  morning. 
She  was  at  first  aided  artificially  at  the  exact  hour, 
but  after  a  few  mornings  when  9.80  arrived,  and  she 


218  THE  FOECE  OP  MIND 

was  taken  out  of  bed,  a  natural  action  was  obtained,  only 
she  sometimes  wanted  to  relieve  the  bowels  before  the 
hour.  This  was  never  allowed  ;  she  was  told  that  to 
be  too  soon  would  prevent  the  cure  as  much  as  being 
too  late.  At  the  end  of  six  weeks  the  bowels  were 
daily  relieved  without  medicine  at  half-past  nine 
exactly  by  the  power  of  the  unconscious  mind  ;  and  at 
the  end  of  six  months  she  had  never  missed  a  day. 
She  has  now  no  further  trouble.  I  mention  this  case, 
for  it  shows  the  power  of  mental  therapeutics  even  in 
the  decline  of  life. 

Now  as  to  the  curative  effect  of  the  patient's  own 
conscious  suggestion  to  the  unconscious  mind,  and 
through  it  on  the  body. 

Typhoid  ' IQ   1837,   Pastor   Chiniquy   got  severe  typhoid. 

Sdi£7a  *ever  *n  Canada,  and  four  physicians  told  his  bishop 
•aint.  there  was  no  hope  of  his  recovery.  On  the  thirteenth 
day  they  said  he  had  only  a  few  minutes  to  live,  and 
his  pulse  could  not  be  felt.  He  then  in  a  vision  saw 
his  favourite  saint,  St.  Anne,  to  whom  he  cried  for 
cure  with  every  power  of  his  soul,  and  he  heard  her 
say,  "  You  will  be  cured."  He  recovered,  and  Quebec 
rang  with  the  miracle.  He  was  examined  by  two 
Catholic  and  two  Protestant  doctors.  Dr.  Douglas,  a 
Protestant,  showed  Chiniquy  his  recovery  was  due  to 
his  being  a  man  of  remarkably  strong  will,  and 
determination  to  resist  death  ;  that  the  will  had  a  real 
power  over  the  body,  and  his  strong  will  had  con- 
quered. Chiniquy  listened,  but  preferred  his  saint, 
and  had  a  votive  picture  painted  of  her  for  50Z.  A 
priest  who  saw  it  then  told  Chiniquy  the  cure  was  no 
miracle,  and  that  most  of  the  crutches  hanging 
round  the  church  were  left  by  impostors ;  and  the  rest 


THE  CURATIVE  POWER  OF  MIND       219 

by  those  cured  by  the  power  of  the  mind  over  the 
body. 

'Till   1858  that  picture,  representing  the  saint  Typhoid 
telling  Chiniquy  he  would  be  cured,  was  in  the  church.  wm^er. 
In  that  year  he  again  got  typhoid  fever  in  Chicago, 
and  once  more  was  given  up  as  dying.     But  this  time 
he  did  not  cry  to  the  saint,  but  made  a  determination 
to  get  better  and  soon  felt  life  returning.   He  then  saw 
the  saints  had  no  part  in  his  previous  cure,  and  took 
his  picture  down  and  burnt  it.' 1 

The  above,  even  if  not  accurate  in  all  details,  1JjrB?l§ 
contains,  I  am  sure,  a  great  truth.  I  had  some  time  will- power, 
ago  a  favourite  nurse  who  always  had  a  superstition 
she  would  die  of  typhoid  fever.  She  contracted  it 
nursing  a  case  of  mine,  and  lay  in  a  county  hospital 
apparently  dying ;  in  the  third  week  of  the  disease, 
in  a  low  typhoid  condition,  and  with  every  appearance 
of  collapse,  but  with  the  mind  clear,  I  went  in  to  see 
her  for  the  first  time,  and  found  her  much  depressed. 
She  told  me  she  was  about  to  die,  and  I  said,  '  Cer- 
tainly.' She  looked  up  and  said, '  Yes,  but  I  mean  it; 
I  always  said  I  should.'  And  I  said,  '  Then  of  course 
you  will.'  She  stared  and  said,  '  Don't  you  mind  ?  ' 
I  said,  '  What's  the  use  of  minding  ?  You  are  going 
to  die  if  you  say  so.'  '  My  saying  so  doesn't  make 
me  die,'  she  said.  '  Perhaps  it  does,'  I  replied,  '  for 
if  you  said  you  wouldn't  die,  you  would  probably  live.' 
I  saw,  as  far  as  I  could  judge,  she  had  reached  that 
point  when  the  throwing  of  the  will  into  either  balance 
would  determine  the  issue.  'Do  you  mean  that?' 
she  said.  '  Yes,  I  do,'  I  said  ;  '  and,  what's  more, 
unless  you  say  so,  I  won't  come  and  see  you  again. 

1  Life  of  Father  Chiniquy,  revised  edition,  London. 


220  THE  FOECE  OF  MIND 

It  is  now  11.30,  and  if  now,  at  this  hour,  you  turn 
your  mind  the  other  way,  and  determine  to  live  and 
not  die,  I'll  do  all  I  can  to  help  you.  You  shall 
have  another  nurse,  and  I'll  get  the  doctor  to  let 
you  have  a  little  champagne.  But  this  resolve  must 
come  from  you.'  She  looked  me  hard  in  the  face, 
and,  seeing  I  meant  it,  and  believing  me,  she 
said  in  deepest  earnestness,  '  I  will ; '  and  from 
that  hour  she  steadily  gained  strength,  and  soon  got 
well.  I  firmly  believe  that  interview  saved  her 
life. 

Cures  by  A  gentleman  in  Manchester,  at  an  hotel,  in  1869, 

fright.  en  route  for  London,  was  seized  with  rheumatic 
fever.  He  had  fearful  pains,  high  fever,  profuse 
perspiration,  and  all  the  symptoms  of  the  disease. 
Being,  however,  most  anxious  to  return  to  London  in 
spite  of  all,  he  persisted  in  being  carried  to  the  night 
express.  There  was  a  serious  collision,  in  which  he 
was  terribly  frightened,  but  not  hurt.  He  had  to 
walk  some  distance  in  the  cold,  but  all  symptoms  had 
gone,  and  the  fever  had  disappeared. 

A  hopeless  epileptic  never  had  another  fit  after 
seeing  his  own  daughter  burnt  to  death. 

In  '  Fraser's  Magazine '  for  May  1873,  there  is 
an  apparently  perfectly  authentic  story  of  a  case  of 
whooping-cough  cured  by  a  good  thrashing. 

Dr.  Buckley  records  this  case.  'A  doctor  was 
called  to  see  a  lady  with  severe  rheumatism,  and 
tried  to  extemporise  a  vapour  bath  in  bed,  with  an 
old  tin  pipe  and  a  tea-kettle ;  and  only  succeeded  in 
scalding  the  patient  with  the  boiling  water  proceed- 
ing from  the  overfull  kettle  through  the  pipe.  The 
patient  screamed,  "Doctor,  you  have  scalded  me,"  and 


THE  CUEATIVE  POWER  OF  MIND       221 

leaped  out  of  bed.     But  the  rheumatism  was  cured, 
and  did  not  return.' 

Tuke  says  that  mental  therapeutics  without 
hypnotism  can  cure  toothache,  sciatica,  painful 
joints,  rheumatism,  gout,  pleurodynia,  colic,  epilepsy, 
whooping-cough,  contracted  limbs,  paralyses,  head- 
aches, neuralgias,  constipation,  asthma,  warts,  scurvy, 
dropsy,  intermittent  fever,  alcoholism,  typhoid  fever, 
and  avert  impending  death. 

Dr.  Murchison  says:  'There  is  good  evidence  Liver, 
that  nervous  influences  may  not  only  cause  functional 
derangement,  but  can  cure  structural  disease  of  the  oured- 
liver.' 

Sydenham  says :  '  Gout  surely  attacks  the  foot, 
but  melancholy  predisposes  to  it.' 

Dr.  Dale  records  the  case  of  a  young  lady  with  severe 
nervous  dyspepsia,  who  was  told  she  could  cure  herself 
by  will  power,  but  failed  for  want  of  sufficient  force. 
The  doctor  then  told  her  lover  to  say  they  could  not 
marry  until  she  was  cured,  when  she  at  once  re- 
covered. 

I  would  call  special  attention  to  this  instructive 
instance  of  the  failure  of  assimilating  mental  thera- 
peutics directly  through  the  conscious  mind  backed 
up  by  conscious  will  power;  whereas  when  used 
indirectly  they  succeeded  at  once.  The  unconscious 
mind  can  rarely  be  made  to  act  by  any  direct  con- 
scious effort  save  under  hypnotism,  but  indirectly  can 
be  made  to  do  almost  anything. 

Dr.  Gibert,  of  Havre,1  in  the  presence  of  Dr. 
Janet  and  others,  washed  a  boy's  hands  covered  with 
warts  in  blue  water,  and  said  if  they  were  not  all 

1  See  Medical  Journal  of  France,  1893. 


222  THE  FOECE  OF  MIND 

gone  in  one  week  he  should  wash  them  in  yellow 
water,  which  the  boy  thought  would  scald  him. 
They  were  all  gone  but  two  or  three  in  the  time. 

It  is  an  undeniable  fact  that  sores  and  ulcers  and 
some  growths   have    been   completely  cured  under 
strong  excitement  of  the  nervous  system. 
Minor  and         Great  importance  attaches  to  the  state  of  mind  of 
laical      the  patient  previous  to  a  major  surgical  operation, 
operations.         rj^  p0wer  Of  mental  treatment  in  gynaecology  is 
well  known,  and  ie  often  much  to  be  preferred  to 
meddlesome  minor  operations. 

A  man  defrauded  his  brother,  and  came  to  his 
doctor  for  anorexia,  dyspepsia,  and  debility.  The 
doctor  discovered  the  mental  factor,  made  him  repay 
his  brother,  and  the  case  was  cured. 

Mind  in  'We  get  temporary  recoveries,'  says  Dr.  Bury,1 

dT^ale.       '  i*1  myelitis  and  locomotor  ataxy,  due  to  the  influence 

of  the  mind  on  the  body.     In  one  case  of  transverse 

myelitis  known  to  me,  a  man  who  was  unable  to  stand 

bathed  at  Holywell.      After  the  dip  he  was  able  to 

walk,  and  the  next   day  he  moved  about  without 

crutches.    The  improvement  lasted  ten  days,  and  then 

the  paralysis  returned,  when  he  came  under  the  care 

of  Dr.  Dreschfeld  at  the  Manchester  Eoyal  Infirmary.' 

Alteratives        AU  alteratives   are  really  habit-breaking  drugs, 

habits,        sucn  as  Plummer's  pill  in  gleet,  arsenic  in  stomach 

cough,  quinine  in  chronic  bronchitis,  &c.,  and  they 

owe  their  efficacy  to  breaking  the  unconscious  memory 

of  the  body. 

I  have  spoken  of  drugs  failing  when  ceasing  to  be 
the  fashion.  In  the  same  way  other  cures  cease  to 
be  efficacious. 

1  Dr.  Bury  in  Bradshaw  Lecture,  190L 


THE  CURATIVE  POWER  OF  MIND      223 

The  moment  the  power  of  Perkin's  metallic 
tractors  was  found  to  be  due  to  the  imagination  of  the 
patient,  as  shown  by  Haygarth's  success  with  wooden 
ones,  they  ceased  to  cure,  and  were  discarded  with 
contempt.  Though  patients  may  not  now  recover  by 
tractors,  we  still  employ  the  mental  factor  in  other 
ways  with  equal  success.  Harness's  electropathic 
belts  cured  many  cases  of  functional  nerve  disease, 
which  reappeared  after  his  exposure. 

In  alluding  to  Harness,  I  would  call  attention  here  NO 
to  the  fact,  that  had  I  given  authentic  instances  of  J£ven  £f " 
the  success  of  quack  remedies  in  these  pages,  I  think 
most  would  have  been  amazed  to  see  what  remark- 
able cures  are  wrought  through  the  mind  by  these 
nostrums.  The  body  of  testimony,  excluding  doubt- 
ful cases,  could  thus  have  been  swelled  ad  libitum. 
But  I  have  refrained,  and  contented  myself  with  the 
fragmentary  and  more  prosaic  testimony  of  the  pro- 
fession ;  not  only  because  such  evidence  is  more 
likely  to  be  accepted  without  question,  but  because 
prejudice  enough  surrounds  my  subject  as  it  is, 
without  stirring  up  more  by  any  recognition  of  these 
men.  They  are  justly  despised  by  the  profession,  not 
so  much  on  account  of  their  ignorance,  as  because 
their  whole  object  is  commercial  profit,  and  their 
methods  often  unscrupulous.  That  they  have  used 
in  ignorance  a  great  power  neglected  in  legitimate 
medicine  is  certainly  no  credit  to  them.  I  shall 
therefore  throughout  this  book  content  myself  with 
orthodox  testimony. 

Summing  up  the  therapeutic  position,  therefore, 
thus  far,  and  considering  how  the  mental  factor  may 
best  be  utilised  in  the  cure  of  ordinary  cases,  we  may 

Q 


224  THE  FOECE  OF  MIND 

say  :  by  the  effect  of  the  presence  and  personality  of 
the  doctor  and  his  surroundings,  by  the  conscious 
employment  of  the  patient's  unconscious  mind  by 
arousing  hope,  joy,  faith,  expectation,  confidence, 
peace,  rest,  &c.,  by  the  psychic  action  of  the  drugs 
used,  and  by  suggestions  given  directly  and  in- 
directly. 

Diseases  as  well  as  therapeutics  may  be  classified 
with  regard  to  the  mental  factor  as  follows  : 

1st.  Into  those  that  recover  by  the  sole  force  of 
the  vis  medicatrix  natura — a  larger  class  than  is 
supposed. 

2nd.  Those  where  this  force  has  to  be  assisted  or 
controlled  by  drugs. 

3rd.  Those  where  active  mental  therapeutics  are 
added  to  it,  to  further  increase  the  action  of  tho 
unconscious  mind. 

4th.  Those  where  all  means  are  insufficient. 

Finally,  I  would  say  that  a  class  cured  by  physical 
means  alone  does  not  exist — for  '  the  force  of  mind 
is  a  therapeutic  agent  in  every  disease.' 


CHAPTEK  XHI 

MENTAL   THERAPEUTICS  IN  FUNCTIONAL 

NERVE  DISEASE 

'  Functional  nerve  diseases  are  mostly  cured  by 
suggestions  presented  in  various  ways.' 

IN  Chapters  VI.,  VII.,  and  VIII.  we  looked  with  some  Mind  M 
care  at  the  question  of  the  connection  of  the  mind  cu^T&nd 
with  the  body  as  a  causative   agent  in  functional 
nerve  diseases  ;  and  here  we  reach  the  corresponding 
question  as  to  the  part  the  mental  factor  plays  in  their 
cure. 

It  is  not  so  long  since  that  the  treatment,  or  M»itre»t- 
rather  maltreatment,  of  functional  neuroses  consti-  JJJJ^^j 
tuted  a  real  opprobrium  medicines. 

The  cases  were  not  wisely  handled,  for  the 
simple  reason  that  they  were  not  understood.  They 
were  not  understood,  partly  from  the  symptoms  not 
being  recognised  as  distinctive,  partly  from  their  very 
vagueness  and  contradictory  nature,  but  far  more 
from  the  impossibility  of  dissociating  many  of  them 
from  some  form  of  malingering,  as  long  as  the 
conscious  mind  was  a  supposed  agent.  Indeed,  it  is 
only  quite  recently  the  true  nature  of  these  cases  has 
been  grasped,  and  the  treatment  of  them  improved. 

The  result  was  everywhere  disastrous,  and 
perhaps  most  so  in  the  way  in  which  it  swelled  the 

•  2 


226  THE  FOECE  OF  MIND 

This  drove  numbers  of  quack  cures,  and  drove  patients  away 

patients  to   ^Qm  ^QgQ  ^Q  understood  them  not,  to   those  who 

remedies.     &^  anv  ra^e  jja(j   a   ^JJQ   perception   of   the   mental 

character  of  the  malady,  and  that  it  required  some 

mental  cure.      I  have  alluded  to   such  a  case  in 

Chapter  I.    All  this  was   a  real,  though  unmeant, 

cruelty  to  the  patients,  who  soon  became  actually 

ashamed  of  their  maladies,  feeling  instinctively  they 

were  suspected  of  fraud.     It  must  not  be  thought 

that  in  these  remarks  I  have  spoken  too  severely,  or 

indicated  a  condition  of  things  that  no  longer  exists. 

Nerve  Listen  for  a  moment  to  the  usual  routine  treatment 

described     of  a  nervous  case  as  described  by  Professor  Binet : 

Jeri£g!m      '  When  one  of  these  victims  to  hypochondria,  who 

are    commonly    called    malades    imaginaires,    has 

recourse  to  medicine  for  the  relief  of  pain  or  some 

other  disturbance,   he  is   usually  told   it  is  of  no 

importance,  that  he  is  fanciful,  and  some  anodyne  is 

carelessly  prescribed.      The  patient,   who  is  really 

suffering  the  pain  he  has  suggested  to  himself,  feels 

convinced  that  his  malady  is  not  known,  and  that 

nothing  can  be  done  for  him.     The  idea  that  his 

complaint  is  incurable  becomes  intense  in  proportion 

to  his  high  opinion  of  the  physician's  skill ;  and  thus 

the    patient,  who  was   suffering  from  the  chronic 

affection  suggested  by  his  imagination,  often  goes 

away  (not  only  uncured,  but)  incurable.' l 

Nerve  The  diseases  grouped  under  the  heads  of  nervous- 

havTbeln    ness>  hysteria,  &c.  are  real  in  origin  and  effects,  and 

^i/ed,     *ormidable  in  their  nature,  and  it  is  high  time  that 

the  ridicule,  the  offspring  of  ignorance,  with  which  they 

1  Binet,  Animal  Magnetism  ttnternat.  Science  Series),  p.  353, 


FUNCTIONAL  NERVE  DISEASES         227 

have  been  so  long  surrounded,  be  entirely  done  away 
with.  These  unhappy  sufferers  have  been  greatly 
wronged  and  often  cruelly  treated. 

This  ignorance  is  partly  due  to  the  fact  that  the  Real 
symptoms  are  generally  subjective  rather  than  ob- 
jective,  and  that  observation  is  not  so  much  needed 
as  reasoning  power.  But  the  real  cause  is  what  we 
have  already  indicated.  It  is  seen  that  the  disease 
is  partly  of  mental  origin ;  and  no  mind  being  known 
or  recognised  by  the  doctor  but  conscious  mind,  he 
concludes  that  the  patient  must  be  aware  of  the  mind 
action  causing  the  disease,  and  is  therefore  to  some 
extent  to  blame.  The  truth,  which  we  hope  will  now 
be  recognised,  is,  that  (as  we  pointed  out  in  an  earlier 
chapter)  all  the  causative  changes  take  place  in  the 
unconscious  mind,  and  that  the  patient  is  wholly 
ignorant  of  anything  but  the  results  in  the  body — 
the  pain  or  disease  suggested.  This  is  the  true 
solution  of  the  difficulty.1 

The  best  cures  of  hysteria  are  naturally,  therefore, 
effected  through  the  unconscious  mind.  If  the  case  through 
is  in  every  way  in  good  health,  and  has  not  entered 
the  vicious  circle  of  dyspepsia  and  debility,  it  may  be 
cured  instantaneously  by  applying  to  the  irritated 
ideal  centres  that  keep  up  the  disease  good  sugges- 
tions, consciously  or  unconsciously,  sufficiently  power- 
ful to  overcome  the  bad  ones.  Their  application  by 
means  of  hypnotism  is  unnecessary,  and  often  in  the 
end  aggravates  the  condition  which  it  is  meant  to 
relieve ;  for  suggestions  are  thoroughly  effectual  with- 
out it,  if  one  uses  the  boldness  and  force  of  which 

'  I  reiterate  here  several  points  already  insisted  on  in  Chapters 
VI.  and  VII.  on  account  of  their  importance. 


228  THE  FOECE  OF  MIND 

Sir  J.  Paget  speaks,  and  has  gained  the  respect  and 
trust  of  his  patient. 

If  all  this  appears  as  novel  as  some  of  the 
terminology  here  used,  it  is  simply  because  mental 
therapeutics  is  still  the  Cinderella  of  medical  sciences, 
for  it  is  yet  very  dubious  orthodoxy  to  suggest  that 
there  can  be  any  means  of  cure  more  potent  than 
those  found  within  the  revered  pages  of  the  British 
Pharmacopeia. 

Bugges-  We  must,  however,  remember  one   great   point 

SoTbe  with  regard  to  suggestion— that  it  is  like  nitrogen. 
*^rbed  Nitrogen  is  the  essential  element  in  all  animal  life  ; 
it  forms  four-fifths  of  the  air  we  breathe,  and  yet, 
curious  to  say,  we  have  no  power  to  use  it  hi  a 
pure  state.  We  can  only  take  it  indirectly,  when 
combined  with  other  substances  in  the  form  of  pro- 
teid  food.  It  is  the  same  with  suggestions.  Not  one 
hysterical  sufferer  in  a  hundred  can  receive  and  profit 
by  them  in  a  raw  state  —that  is,  consciously ;  they 
must  generally  be  presented,  as  we  have  said,  in- 
directly to  the  unconscious  mind  by  the  treatment 
and  environment  of  the  patient.  An  electric  shock 
often  cures  slight  hysterical  diseases  instantaneously, 
acting,  as  it  does,  on  the  unconscious  mind  through 
the  conscious. 

it  is  best  No  doubt  it  would  be  easier  if  we  could  say  to 
romn  und  ^ese  sun?erers>  '  The  disease  is  caused  by  suggestions 
from  ideal  centres ;  and  to  cure  it,  all  you  have  to 
do  is  to  believe  you  are  well.'  Still,  as  it  would  be 
impossible  for  us  to  take  our  nitrogen  pure  from  the 
air,  the  mind  cannot  as  a  rule  be  thus  acted  on 
directly  when  the  brain  is  unhealthy.  Suggestion 
must  be  wrapped  up  in  objective  treatment,  directed 


FUNCTIONAL  NERVE  DISEASES         229 

ostensibly    and    vigorously    to  the    simulated    dis- 
ease.1 

It  is  not,  however,  enough  in  mental  therapeutics  Baa  «g. 
to  present  good  suggestions;  we  must  also  remove  mu8t°bJ 
previous  bad  ones.  Such  a  patient  must  therefore  be  remoyed< 
isolated  to  avoid  conversations  about,  and  sympathy 
being  shown  with,  the  patient's  sufferings;  all  of 
which  keep  up  the  action  or  vibration  of  the  diseased 
ideal  centres.  The  range  of  mental  therapeutics  is, 
however,  by  no  means  limited  to  hysterical  diseases. 
The  powers  of  the  unconscious  mind  are  such  that 
we  can  place  no  limits  to  its  influence.  When  the 
mind  is  really  unsound,  it  is  interesting  and  remark- 
able— though  quite  intelligible — to  notice  that  mental 
therapeutics  generally  fails ;  obviously  because  the  con- 
scious psychic  element  through  which  it  should  act  is 
in  itself  disorganised.  From  what  has  been  said,  it  will 
be  gathered  that  in  ordinary  and  some  nervous  diseases, 
while  mental  therapeutics  acts  largely  through  the 
unconscious  mind,  it  can  also  be  successfully  presented 
directly  to  the  intelligence ;  and,  on  the  other  hand, 
in  true  hysteria  nearly  all  the  work  has  to  be  done 
unconsciously,  the  conscious  mind  being  fixed,  not  on 
mental  therapeutics,  but  on  the  outward  means  used. 
Suggestions  are  often  advantageously  directed  to  the  JJ6^™^* 
sound  parts  of  the  body,  leaving  the  diseased  part 
severely  alone. 

John  Hunter  gives  a  good  hint  here.    He  was  gjj^ 
asked  to  be  magnetised,  and  being  told  he  would  feel  .tr*ugem. 
it  at  the  roots  of  the  nails  of  his  hand,  he  fixed  his 
whole  attention  on  his  great  toe,  and  so  frustrated 

1  For  the  value  of  surgical  treatment  in  some  internal  neuralgias, 
eee  paper  by  Sir  F.  Treves,  British  Medical  Journal,  March  10, 1898. 


230  THE  FORCE  OF  MIND 

the  phenomena.  I  employed  this  device  successfully 
some  years  ago  in  the  case  (that  I  will  speak  of  more 
fully  later  on)  of  a  girl  with  a  contracted  and 
withered  arm  which  had  been  massaged  and  f  aradised, 
with  the  result  of  making  it  more  and  more  rigid.  I 
neglected  it  entirely,  and  fixed  the  attention  on  the 
other  parts  of  the  body  by  vigorous  massage,  &c.,  with 
the  result  that  the  bad  arm,  left  quite  alone,  got 
perfectly  well. 

ideal  It  is  important  fully  to  understand  that  when  the 

m^deL  brain  is  restored  to  health  by  good  nerve  tissue  and 
disease6*1  nea^n7  blood,  it  can  be  made  by  suggestion  to  exercise 
as  beneficial  an  influence  over  the  body  as  previously 
it  exercised  a  harmful  one.  If  ideal  centres  can  pro- 
duce ideal  diseases,  surely  the  rational  cure  is  to  first 
bring  these  ideal  centres  into  a  healthy  condition,  and 
then  make  them  the  means  of  curing  the  ideal  dis- 
ease. Mental  disease  requires,  and  can  ultimately 
only  be  cured  by,  mental  medicine.  When  will  this 
be  understood  ?  And  when  will  nauseous  drugs  cease 
to  be  ministered  to  a  mind  diseased  ? 

Sir  Russell        Of  the  usual  remedies  given,  Sir  Eussell  Eeynolds 

5?SJ?"     says :   « The  whole  list  of  anti-hysteric  remedies— 

fJS^i       musk,  castor,  valerian,  and  the  like — appear  to  have 

this  one  property  in  common :  that  they  do  no  good, 

and  delay  the  real  treatment  of  the  case,  which  is  not 

one  to  be  cured  by  nauseous  "  gums,"  but  largely  by 

mental,  moral,  and  social  management.' 

Fi*e<HaeaB         Suggestion  in  hysteria  is  said  to  cure  the  physical 

be  too  °      condition  through  an  intermediate  emotional  change — 

3ult      in  short,  by  a  feeling  rather  than  a  thought.     It 

must  of  course  begin  with  an  idea ;   but  when  the 

doctor  moralist  tries  to  inculcate  a  valuable  fixed  idea, 


nerve 


FUNCTIONAL  NEEVE  DISEASES         231 

it  must  not  be  too  far  off  or  difficult  of  comprehension. 
Such  ideas  often  fail  of  their  effect  with  indolent 
neuropaths,  who  are  all  more  or  less  afflicted  with 
mental  myopia.  The  moment  the  new  idea  or  sug- 
gestion is  adopted,  it  begins  to  act  through  the  un- 
conscious mind  exactly  like  a  drug. 

De  Fleury  points  out  that l  a  good  doctor  for  nerve  De  Fleury 
patients  is  also  necessarily  a  good  hygeist  for  the  dSctorT 
mind  ;  neurosis  being  in  fact  only  a  bad  habit  which 
the  '  cerebral  action '  (another  synonym  for  the  un- 
conscious mind)  has  contracted. 

Dr.  Playfair  pursues  this  thought  further.    He  Dr.  pi»y. 
says : 2  '  The  rank  weeds  of  neurotic  disease  will  only  fa 
flourish  in  suitable  soil.     Improve  this,  and  the  un- 
healthy growth  will  disappear.    That  this  can  be 
done  by  drugs  or  health  resorts,  all  experience  shows 
is  an  impossibility;  these  as  a  rule  only  make  the 
patients  go  from  bad  to  worse.     Get  rid  of  all  these, 
put  the  patient  under  a  thorough  physical  and  moral 
training,   and    it    is    surprising    how    all  neuroses 
vanish.' 

This  rational  and  psychic  treatment  is  certainly  JJj^jJ 
gaining  ground.     It  has,  of  course,  a  negative  and  a  tive  side  at 
positive  side.     The  negative  consists  in  removing  in- 
jurious influences  from  the  patient's  mind,  whether 
they  be  objective  from  the  outer  world,  or  subjective 
from  the  patient's   own  disordered  thoughts.      The 
positive,  in  infusing  into  the  patient's  mind  curative 
mental  influences  such  as  hope  and  rational  ideas, 
which  tend  to  counteract  the  unsound  mental  action. 
It  is  needless  to  say  that  a  successful  doctor  requires 

1  De  Fleury,  Medicine  and  the  Mind,  p.  221. 

•  Dr.  Playfair,  Psychological  Dictionary  of  Mtdiobu. 


232  THE  FOECE  OF  MIND 

in  this  a  combination  of  tact,  knowledge  of  human 
nature,  patience,  and  temper  that  all  cannot  possess. 
Such  tact  and  character  are  every  whit  as  condu- 
cive to  success  as  a  scientific  equipment. 

impressive        As  I  have  already  said,  suggestions  in  the  patient's 

means.  ordinary  state  are  greatly  strengthened  by  adjuvants  in 
the  form  of  impressive  means,  more  or  less  elaborate ; 
in  the  hypnotic  condition  these  are  not  needed,  as 
the  patient's  '  unconscious  mind '  is  then  entirely 
accessible. 

k>S.°f  Touch  is  often  a  material  aid  in  the  conveyance 

of  thoughts,  as  wires  aid  telegraphy.  In  some  cases 
a  decided  manner,  with  a  hand  laid  firmly  on  the 
patient's  arm,  will  enable  him  to  assimilate  sugges- 
tions otherwise  inoperative. 

Some  can  do  more,  and  can  cure  directly  by  bold 
assurance.  A  doctor  who  has  the  patient's  full  con- 
fidence may  cure  a  patient  by  telling  him  he  is  cured. 

?°Id_  _.  Such  cases,  however,  are  rare.     Dr.  Paul  Edwards, 

of  Paris,  cures  his  patients  thus.  The  therapeutic  force 
is  in  himself.  But  these  are  exceptional  methods,  and 
my  desire  is  rather  to  write  for  the  medical  man 
generally,  and  prove  in  this  and  following  chapters 
that  '  functional  nerve  diseases  are  mostly  cured  by 
suggestions  presented  in  various  ways.' 


assurance. 


CHAPTER  XIV 

THE   TBEATMENT   OF  FUNCTIONAL  NERVB 
DISEASES 

1  Success  in  the  treatment  of  neurasthenia  dependi 
equally  on  psychical  and  physical  details.' 

IN   considering  briefly  a   few  points   in   the   treat-  P«yohic 
ment  of  functional  nerve   disease,  more  especially 
neurasthenia,   we   shall   find   psychic  and  physical 
methods  here  go  hand  in  hand. 

I  have  already  indicated  the  leading  points  of 
diagnosis  between  neurasthenia  and  neuromimesis  or  condition 
hysteria,  and  now  in  treatment  we  find  the  difference  fir8*' 
no  less  marked.  The  psychic  treatment  in  neur- 
asthenia cannot  be  effectively  applied  until  the  physical 
condition  of  the  nervous  centres  is  restored  to  health, 
and  then  often  little  or  nothing  is  needed.  In  hys- 
teria, on  the  other  hand,  the  psychic  treatment  is  the 
more  important,  though,  being  so  often  wrapped  up 
in  physical  appliances,  it  is  not  always  recognised 
as  such.  I  will  now  proceed  to  run  through  some  Four 
leading  points  that  make  for  success  in  the  treat- 
ment  of  functional  nerve  disease,  more  especially  of 
neurasthenic  patients,  and,  to  make  the  hints  given 
as  clear  and  as  useful  as  possible,  it  may  be  well 
to  crystallise  them  around  four  centres :  First,  the 


234  THE  FOECE  OF  MIND 

physician ;  secondly,  the  patient ;  thirdly,  methods 
of  treatment ;  fourthly,  various  details.  In  other 
words — personality,  diagnosis,  treatment,  and  details. 

To  take,  then,  the  doctor  first,  an  order  recognised 
by  Dr.  Clifford  Allbutt  when  he  says :  '  Suggestion 
and  the  personal  ascendency  of  the  physician  enter  so 
largely  into  all  methods  of  treatment  (of  neurasthenia) 
that,  to  speak  honestly,  we  find  great  difficulty  in 
making  much  way  (when  these  have  failed)  with  old 
disillusioned  patients.' l 

The  first  point  one  would  make  in  connection  with 
needed.  y  the  physician  (in  spite  of  much  that  has  been  written, 
and  against  the  practice  of  many  noted  neuropaths) 
is  that  one  of  the  first  conditions  of  success  is  sym- 
pathy, and  one  of  the  chief  causes  of  failure  is  the 
want  of  it. 

I  do  not  say  it  need  be  always,  or  even  frequently, 
shown ;  but  believing  as  I  do  in  the  unconscious  mind, 
and  the  quick  relation  of  one  mind  to  another  when 
in  harmony,  I  have  no  doubt  whatever  that  real  sym- 
pathy is  always  felt  wherever  it  exists  in  the  physician 
for  the  sufferer,  though  it  be  not  shown ;  the  proof 
being  that  it  gives  a  confidence  in  his  skill,  and  a 
restful  feeling  of  being  understood — that  is  no  mean 
factor  in  the  cure. 

she 'can-  To  feel  this  sympathy  one  must  believe  in  the 
reality  of  the  sufferings  of  the  patient,  and  dismiss 
absolutely  the  blight  of  suspected  malingering.  One 
must  grasp  the  truth  of  the  brilliant  dictum  of  Sir 
James  Paget,  who  declared  that  while  the  patient  says 
she  '  cannot '  and  the  nurse  that  she  '  will  not,'  the 
truth  is  that  she  '  cannot  will.' 

1  Dr.  Clifford  Allbutt,  System  of  Medicine,  viii.  180. 


FUNCTIONAL  NEEVE  DISEASES         235 

Let  us  remember,  as  we  have  said,  that  a  disease 
of  the  imagination  is  not  an  imaginary  disease, 
and  that  pain,  in  its  last  analysis,  is  a  mental  rather 
than  a  physical  fact,  for  its  reality  does  not  in  the 
least  depend  upon  its  resting  on  any  definite  physical 
basis. 

To  tell  neurasthenics  or  hysterics  that  there  is 
nothing  the  matter  with  them  because  no  clear 
physical  basis  can  be  discovered  for  the  symptoms 
complained  of — unless  done  in  exceptional  cases, 
deliberately  for  a  definite  purpose  -is  to  confess 
oneself  unfit  to  deal  with  functional  nerve  diseases. 

As  slowly,  very  slowly,  the  enormous  powers  of 
the  unconscious  mind  over  the  body  are  beginning  to 
be  dimly  perceived,  such  crude  and  false  statements 
are  becoming  rarer ;  but  they  are  still  common  enough 
amongst  those  whose  opinions  are  founded  solely  upon 
physical  diagnosis. 

The  next  qualification  in  the  physician  is  patience, 
and  this,  I  think,  is  different  from  mere  endurance,  and  pen*, 
and  really  depends  upon  the  first  quality— sympathy. 
It  is  only  those  who  know  the  tortures  undergone  by 
functional  nerve  sufferers,  the  pariahs  and  outcasts 
amongst  patients  and  doctors,  and  that  feel  for  their 
sufferings,  that  can  possibly  put  up  with  the  trying 
nature  of  the  sufferer  and  his  multifarious  and  often 
apparently  incurable  troubles. 

The  lack  of  this  virtue  in  doctors  fills  our  holiday 
and  health  resorts  abroad  with  patients  sent  there 
because  the  doctor  could  not  stand  the  strain  at  home, 
and,  recognising  his  resulting  impotence,  ordered 
travel  as  the  best  way  out. 

Allied  to  patience  is  perseverance.    The  despon- 


236  THE  FOECE  OP  MIND 

dency  of  the  patient,  the  scepticism  of  relations,  the 
continued  and  heavy  expense  to  them  over  which  the 
physician  has  no  control,  and  the  want  of  any  signs 
of  improvement,  it  may  be  for  weeks,  render  this 
virtue  one  of  the  most  difficult  to  practise.  And  yet 
for  want  of  it  how  many  patients  go  unrelieved,  how 
many  incipient  cures  are  nipped  in  the  bud,  and  how 
many  successful  methods  are  prematurely  abandoned 
as  failures  !  If  we  have  sound  grounds  for  believing 
our  treatment  is  rational ;  if  we  have  seen  successful 
results  from  it  in  previous  cases,  and,  above  all,  if 
there  is  the  least  glimmer  of  improvement,  let  us 
persevere  on  and  on.  There  is  no  space  here  to 
adduce  cases  in  proof  of  this,  but  I  have  one  in  mind 
that,  after  defying  every  doctor  and  every  variety 
of  Weir-Mitchell  and  similar  'cures,'  was  at  last 
successfully  restored  to  health  mainly  by  being 
persistently  kept  in  bed  for  five  months  on  end  by 
a  doctor  who  would  not  be  beaten. 

Not  too  Closely  connected,  again,  with  this  is  the  question 

jjj^1  but  of  firmness.  Curious  as  it  may  seem,  it  is  easy  to  be 
enough.  too  firm,  and  still  easier  not  to  be  firm  enough.  The 
path  of  success  here  undoubtedly  lies  in  the  golden 
mean  between  the  two.  Be  inflexible  as  cast  iron  in 
things  essential ;  flexible  as  steel  in  all  matters  non- 
essential,  and  never,  as  is  so  common,  inflexible  from 
mere  doggedness,  but  always  intelligently.  This 
gives  confidence,  brings  success,  and  avoids  friction 
with  patients  and  friends. 

Tact  is  Perhaps   this  question  really  depends   upon  the 

tend!1        next  8reat  virtue,  without  which  neurasthenics  cannot 

be  successfully  treated,  and  that  is  tact.     Tact  is  the 

unconscious  mental  touch,  the  tactus  eruditus,  by 


FUNCTIONAL  NEEVE  DISEASES         237 

which  one  mind  feels  another ;  and  just  as  a  physician's 
physical  tactile  sense  is  educated  to  discern  much  by 
mere  touch,  so  can  mental  tact  help  the  nerve  doctor 
immensely  along  his  difficult  path.  Take,  for  instance, 
the  one  question  of  whether  to  make  light  of  any 
particular  symptom  or  to  treat  it  quite  seriously. 

The  answer  does  not  in  a  neurasthenic  in  the 
least  depend,  as  the  doctor  may  naturally  think,  upon 
the  amount  of  obvious  physical  bases  upon  which 
that  symptom  may  rest,  but  on  the  effect  on  the 
patient's  mind  of  your  levity  or  gravity ;  and  to 
ascertain  this  effect  beforehand  is  the  highest  out- 
come of  tact. 

For  it  must  ever  be  recognised,  and  may  here 
be  categorically  asserted,  that  neurasthenia  partly, 
and  hysteria  or  neuromimesis  almost  wholly,  are 
diseases  of  the  unconscious  mind,  of  unconscious 
suggestion ;  and  it  is  in  this  very  fact  of  their  un- 
conscious nature  that  they  differ  from  all  forms  of 
malingering,  which  always  imply  conscious  fraud. 
Whatever  diseased  physical  conditions  may,  therefore, 
coexist,  require  treatment,  but  the  mental  condition 
is  undoubtedly  the  more  important,  and  is  the  one 
which  in  every  case  requires  the  greatest  judgment 
and  tact.  Most  medical  men,  I  believe,  are  inclined 
to  glorify  their  own  particular  branch  of  the  pro- 
fession ;  but  one  cannot  but  see  that  in  pursuing  to 
its  recesses  and  in  curing  diseases  produced  by  such  a 
mysterious  agent  as  the  unconscious  mind,  one  has  to 
employ  power  and  means  of  a  very  different  nature 
from  the  comparatively  simple  and  straightforward 
processes  of  purely  physical  medicine  and  surgery. 

I  may,  perhaps,  say  just  a  word  on  the  value 


238  THE  FORCE  OF  MIND 

Honesty  to  of  honesty  with  these  patients ;  for  it  is  a  word  by  no 
mtereatl  means  limited  to  its  ordinary  sordid  interpretation. 
I  mean  absolute  honesty  in  considering  and  acting 
solely  in  the  patient's  interests,  as  distinguished,  not 
from  the  doctor's,  but  from  the  parents,  friends,  and 
relatives,  and  others  whose  counsels  and  pleadings  so 
often  turn  aside  the  otherwise  sound  judgment  of  the 
physician. 

Lastly,  success  depends  upon  a  power  of  attention 
to  details  that  is  not  always  found  in  minds  broad 
enough  to  grasp  the  case  as  a  whole.  Minds,  as 
has  been  pointed  out,  are  generally  characterised 
by  observation  or  imagination.  The  former  quality 
gives  accuracy  in  details,  the  latter  broad  and  wide 
views.  The  combination  is  rare,  and  those  who 
possess  it  are  generally  masters  of  their  profession, 
and  in  nerve  diseases  this  union  is  of  especial  value. 
The  doctor  who  knows  and  sees  that  his  patient  is  not 
disturbed  at  night  after  the  last  massage  ;  who  gives 
exact  orders  as  to  her  detailed  routine  throughout  the 
day ;  who  ascertains  she  is  not  roused  and  agitated 
by  the  noisy  cleaning  of  grate  and  room  early  in  the 
morning,  will  do  much  to  ensure  the  general  success 
of  his  elaborate  treatment. 

A  capacity  for  taking  pains  and  for  arranging 
details  of  treatment  may  turn  the  scale  from  failure 
to  success  in  a  doubtful  case.  So  much,  then,  with 
extreme  brevity  for  the  doctor  and  his  personal 
powers. 


Tha  Let  us  now  consider,   in  the  second  place,  the 

dfat^sis^  con^^i°ns  0*  success  in  connection  with  the  patient 

and  the  diagnosis.    The  first  point,  perhaps,  to  de- 


FUNCTIONAL  NERVE  DISEASES         239 

cide,  on  which  successful  treatment  may  turn,  is 
whether  mind  or  body  (including  in  the  latter  all 
nerve  tissues)  plays  the  chief  part  in  the  disease. 
Briefly  and  simply  it  may  be  said  that  nerve  cases 
divide  themselves  into  one  category  or  the  other. 

Cases  of  true  neurasthenia,  that  is,  of  nerve  irrita-  Hysteria 
tion  or  exhaustion,  dependent  upon  external  causes  or  ment&i 
upon  physical  lesions  within,  are   mainly  physical,  than 
the  mind,  conscious  or  unconscious,  being  only  affected  *•&«"* 
in  a  secondary  degree,  as  a  result  of  the  nerve  con- 
dition. 

On  the  other  hand,  all  cases  of  hysteria  or  neuro- 
mimesis  contain  a  distinct  mental  element,  and  that 
is  an  affection  of  the  unconscious  mind  over  and 
above  any  mere  question  of  nerve  condition ;  while 
all  other  cases  of  delusions,  fixed  ideas,  true  melan- 
cholia, and  other  slight  aberrations,  reveal  a  primary 
disturbance,  want  of  balance  or  unsoundness  of  the 
conscious  mind  or  reason,  and  these  are  generally 
recognised  as  true  mental  cases.  Cases  of  hysteria, 
however,  are  not  generally  regarded  as  distinctly 
mental,  owing  to  the  fact  that  still,  as  a  rule,  in 
England  mind  is  sought  to  be  limited  to  conscious- 
ness. In  France,  however,  Charcot,  quoted  by  Fere, 
says, '  Hysteria  is  a  psychical  malady  par  excellence.' 
Here,  however,  from  the  fact  of  its  seat  being  the 
unconscious  mind,  which  produces  in  the  body  the 
symptoms  complained  of,  it  occupies  an  intermediate 
place  between  the  pure  nerve  lesions  on  the  one  hand 
and  the  distinct  mental  troubles  on  the  other. 

The  value  of  this  broad  distinction  between  nerve 
and  mental  troubles  becomes  obvious  when  we  con- 
sider treatment.  For  instance,  we  may  say  generally 


240  THE  FOECB  OF  MIND 

that  where  there  is  any  mental  taint,  confinement  to 
bed  often  does  as  much  harm  as  in  cases  of  disordered 
nerves  it  does  good.  The  question  of  a  sound  con- 
scious mind  must  be  decided  first.  This  is,  of  course, 
not  the  same  as  a  consciously  sound  mind.  Most 
mental  cases  are  distinguished,  indeed,  by  the  fact 
that,  although  their  conscious  reason  is  distorted, 
they  are  themselves  unconscious  of  the  fact.  This 
question  has,  of  course,  a  great  bearing  on  prognosis. 
No  rapid  or  permanent  cure  can  be  safely  predicted 
where  the  mental  balance  is  destroyed  or  even  un- 
stable, and  many  forms  of  nerve  treatment  are  here 
contra-indicated. 

irritation          Proceeding  now  from  mental  and  hysterical  cases 
orphans-   to  neurasthenia  proper,  the  point  to  determine  is  the 
stage  and  character  of  the  disease  ;  as  to  whether  the 
nerve  centres  are  in  a  state  of  irritation  or  of  ex- 
haustion or  of  both. 

In  neurasthenia  as  distinguished  from  hysteria 
the  exciting  cause  at  any  rate  is  generally  external 
and  apparent,  but  the  treatment  of  nerve  irritation 
obviously  must  differ  greatly  from  that  of  nerve 
exhaustion. 

I  find  that  success  is  greatly  hindered  if  the 
patient  has  been  already  the  victim  of  previous 
failures.  As  Dr.  Allbutt  has  pointed  out,  these 
always  act  prejudicially  in  sapping  the  confidence  and 
courage  of  the  patient.  To  me  this  has  always  been 
a  most  difficult  complication  to  deal  with. 

The  mechanical  routine  of  a  so-called  Weir- 
Mitchell  'cure'  is  now  so  well  known  and  so  ab- 
surdly regarded  as  a  universal  panacea,  that  this  or 
something  else  has  often  been  tried  unsuccessfully 


FUNCTIONAL  NEEVE  DISEASES         241 

before  you  see  the  patient,  with  the  result  that  any- 
thing  approaching  the  same  methods  is  already 
regarded  with  suspicion ;  though  it  may  essentially 
differ,  and  result  in  success  instead  of  failure. 

Another  element  of  success  in  the  patient  is  con-  Co-op«ra. 
fidence  in   the  doctor  and  nurse.    I  add  'nurse,'  SSto/and 
because  many  physicians  are  not  aware  how  this  nur8e> 
person  can  weaken  or  wholly  frustrate  all  efforts  at  a 
cure.     A  case  occurs  to  me  that  treated  by  the  Weir- 
Mitchell  method    twice  only  resulted   each   time  in 
failure  and  actual  loss  of  weight.     Secret  sapping  of 
the  doctor's  influence  with  neglect  of  orders  was  the 
cause  in  one  ;  and  open  rupture  of  the  two  neutralis- 
ing all  efforts  in  the  other.     The  case  was  difficult, 
but  with  agreement  between  the  two  was  eventually 
successfully  treated. 

I  must  not  omit  here,  as  distinct  from  all  diagnosis 
of  the  disease,  and  as  a  great  element  of  success,  a 
close  study  of  the  patient's  personality  and  mental 
calibre. 

This  so  often  requires,  even  in  two  suffering  from 
the  same  symptoms,  a  course  of  treatment  in  one 
case  entirely  different  from  that  required  by  another. 

The  personal  factor  is  so  comparatively  valueless 
in  ordinary  physical  diseases  such  as  pneumonia  or 
gout,  that  one  is  apt  never  to  consider  it,  until  one 
finds  from  disastrous  experience  that  its  proper  con- 
sideration is  in  its  way  quite  as  important  as  accurate 


Lastly,  in  concluding  the  study  of  the  patient  as 
a  factor  of  success,  I  would  strongly  advise,  if  the 
cause  of  some  symptoms  still  remains  obscure,  careful 
consideration  of  the  question  of  sexual  agencies,  both 

»  2 


242  THE  FOKCE  OF  MIND 

physical  and  mental,  natural  and  unnatural,  for  the 
extent  to  which  this  latter  is  a  factor  is  little  known 
to  many  physicians. 

Methods  of  I  now  come  to  the  methods  of  cure,  and  here  it  is 
obvious  that  though  success  depends  largely  upon  the 
physician,  largely  upon  the  diagnosis,  it  must  depend 
still  more  largely  upon  the  use  of  right  and  adequate 
means. 

Hand-  In  the  first  place,  then,  with  neurasthenics,  in  the 

™£^ig  greater  number  of  cases  '  cast-iron  systems  '  of  treat- 
machine-  ment  turning  out  '  machine-made  '  cures  stand  con- 
'cnrea.'  demned  in  theory  and  in  practice.  If  one  may  say 
a  word  from  practical  experience,  it  is  that  the  chief 
cause  of  the  failures  I  have  come  across  has  been  the 
ordering  of  such  and  such  cure  by  name  (involving 
some  fixed  routine  and  surroundings),  that  failed 
because  not  adapted  or  adaptable  to  the  patient's 
special  needs.  Of  course,  wherever  a  doctor  has  any 
fixed  system  or  wishes  to  save  himself  trouble,  there 
ready-made  expedients  are  very  tempting;  but  we 
must  here  lay  down  as  an  important  condition  of 
success  the  making  a  system  or  treatment  to  suit 
the  patient,  rather  than  a  patient  to  suit  the  treat- 
ment. 

Methods  It  is  far  otherwise  when  dealing  with  any  definite 

adequate.  an<l  well-known  lesion,  such  as  enteric.  Here  the 
more  of  routine  and  fixed  treatment  often  the  better. 
I  have  spoken  of  the  adequacy  of  the  methods 
used.  This  adequacy  must  not  be  judged  by  the 
amount  of  potent  drugs  prescribed,  or  the  violence  or 
expense  of  the  agencies  employed.  They  may  range 
from  the  most  elaborate  combinations  of  psycho- 


FUNCTIONAL  NEKVE  DISEASES         243 

physical  treatment  conducted  in  a  well-appointed 
home  with  every  possible  adjunct,  down  to  a  few 
simple  prescriptions,  or  even  short  medical  talks,  or 
a  change  of  environment  or  occupation,  or  mere  rest, 
pure  and  simple. 

No  method  can  be  decried  as  trivial  that  succeeds 
in  curing  the  patient ;  but,  on  the  contrary,  that  plan 
is  best  that  arrives  at  this  result  with  the  least  time, 
trouble,  and  expense. 

I  may  add  that,  although  the  treatment  adopted  Doctor 
may  be  tentative  or  experimental,  its  aspect  to  the  ™0gBm»tio 
patient  should  always  be  fixed,  dogmatic,  and  definite. 
Whatever  balancing  of  different  methods  may  have 
passed  through  the  doctor's  mind,  all  should  be  firm 
and  defined  to  the  patient. 

Even  when  the  treatment  accords  with  the  patient's 
own  ideas  and  wishes,  it  should  never  be  ostensibly 
adopted  for  this  reason. 

Most  methods  involve  the  use  of  nurses  or  trained 
attendants,  or  companions  of  some  sort,  and  here  is 
a  frequent  cause  of  non-success.  Doctor,  diagnosis, 
method— all  are  right,  and  yet  there  is  no  cure  because 
the  subordinate  agents  are  inefficient. 

This  is  not  the  place  to  enlarge  upon  the  reason 
why  this  is  so  frequent,  based  as  it  is  upon  the  non- 
recognition  of  the  great  need  there  is  for  a  class 
between  the  three  years  hospital-trained  and  starched- 
and-ironed  aseptic  nurse  of  the  period  and  the  de- 
pressing mental  attendants  upon  the  insane.  The 
neurasthenic  nurse  is  a  being  yet  to  be  evolved  as  a 
definite  product,  but  is  sometimes  met  with  as  a  chance 
growth  in  out-of-the-way  places,  frequently  painfully 
ignorant,  alas  !  of  the  simplest  hospital  routine. 


244  THE  FOECE  OF  MIND 

The  ordinary  nurse  dislikes  the  neurasthenic  case 
largely  because  she  does  not  understand  the  reality 
of  the  disease  in  the  absence  of  physical  lesions,  and 
partly,  also,  because  in  hysterical  cases  there  is  not 
only  the  appearance  of  fraud,  but  often  a  perverted 
mental  bias  that  takes  pleasure  in  fault-finding,  and 
setting  the  nurse  against  the  doctor,  and  vice  versa. 

It  is  well  for  the  doctor  to  remember  this,  and, 
even  when  a  nurse  has  to  be  changed,  to  uphold  the 
nurse  to  the  patient  whenever  possible,  even  on  thera- 
peutic grounds. 

Nascitur  Ndscttur  non  fit  is  undoubtedly  the  distinguishing 
motto  of  the  nerve  nurse,  though  the  'fitting'  is 
most  necessary  and  useful  also,  but  until  this  is 
recognised  and  the  nurses  are  to  be  had,  what  is  the 
doctor  to  do  ?  Well,  of  course  he  has  to  cure  his 
patient.  At  present,  for  want  of  adequate  help,  the 
cure  has  often  to  be  effected  by  his  own  personal  in- 
fluence and  visits  to  an  extent  that  would  not  be  in 
the  least  necessary  were  our  training  system  more 
adequate  and  really  efficient  helps  to  be  had.  This  is 
all  very  well  for  patients  that  can  pay,  but  is  natu- 
rally very  expensive. 

The  outcome  is,  therefore,  clearly  this,  that  the 
treatment  of  all  difficult  neurasthenic  cases  is  neces- 
sarily, and  from  causes  quite  beyond  the  doctor's 
control,  far  more  expensive  than  that  of  any  other 
class  of  disease  (excluding,  of  course,  any  involving 
major  surgical  operations),  and  far  more  expensive 
than  it  need  be  were  efficient  nurses  to  be  had. 
Women  This  question  of  nurses  raises  that  of  homes  gene- 

men  reTt,     rally.     In  the  first  place,  neurasthenics  cannot,  as  a 
*t  home,     ruje^  ^  cure(j  JQ  ft^  own  nomes>  f or  wnat  they  one 


FUNCTIONAL  NERVE  DISEASES         245 

and  all  need  is  rest  in  some  form.  Now,  to  women 
home  is  the  sphere  of  the  greater  part  of  their  work, 
to  the  man  only  is  it  (with  exceptions)  the  place  of 
rest.  Hence,  home  is  obviously  not  the  environment 
needed  for  women,  and  for  other  reasons  men  also 
are  cured  more  certainly  and  expeditiously  away 
from  their  own  family  circles.  This  necessitates  the 
nursing  home  as  an  indispensable  adjunct  for,  at  any 
rate,  part  of  the  cure. 

Now,  it  is  not  too  much  to  say  that  the  quality  of 
this  home  largely  determines  the  question  of  success 
in  the  treatment.  Homes  are  so  frequently  unsatis- 
factory that  many  physicians  have  been  driven  to 
run  their  own.  This  has,  of  course,  its  advantages, 
but  it  has  great  and  serious  drawbacks.  Of  course,  I 
am  here  not  speaking  of  surgical  homes,  or  of  any 
treatment  but  that  of  neurasthenics. 

Personally,  I  have  never  been  able  to  get  over  the 
professional  feeling  that  a  physician  ought  to  look  to  run  home* 
his  fees,  and  to  his  fees  alone,  for  payment  for  his 
services ;  and  should  not  directly  or  indirectly  run  a 
boarding-house  under  any  name,  or  share  in  the 
profits  if  derived  from  his  patients. 

It  may,  of  course,  be  urged  that  a  doctor  can  have 
his  own  nursing  home,  and  yet  have  nothing  to  do 
with  its  management  or  profits.  In  this  case,  of 
course,  it  is  hardly  his,  though  his  patients  may  go 
there  ;  and,  of  course,  he  fails  to  have  the  perfectly 
free  hand  in  dietaries— so  all-important— that  he  has 
when  its  pecuniary  management  is  in  his  hands. 

It  may  not,  indeed,  be  difficult  to  show  that  it  if 
to  the  patient's  own  interest  that  the  home  should  be 
run  by  the  doctor,  and  many  medical  men  will  see  no 


346  THE  FORCE  OP  MIND 

weight  whatever  in  what  I  urge  against  making  a 
profit  from  board  and  lodging.  One  can  in  this  only 
speak  for  oneself,  and  for  all  others  like-minded. 

At  any  rate,  whether  the  home  be  the  doctor's  or 
the  matron's,  it  must  be  one  where  the  dietary  is 
practically  unlimited,  where  the  food  can  be  relied  on 
to  be  of  the  best  and  well  cooked,  and,  not  least, 
punctually  served  with  cleanliness  and  nicety.  The 
room  should  be  quiet  and  airy,  and  at  any  rate 
major  surgical  operations  should  not  be  conducted  in 
the  home.  If  possible,  it  should  have  some  private 
grounds  or  garden  attached  to  it. 

The  matron  or  sister  may  or  may  not  actively  co- 
operate in  the  treatment,  but  should,  at  any  rate,  avoid 
the  slightest  adverse  comment  on  any  methods  she 
may  or  may  not  understand  or  agree  with.  She 
should  be  prepared  to  change  the  nurse  at  the  doctor's 
request  till  the  patient  is  suited,  and  to  promptly 
carry  out  all  his  orders. 

A  few  Finally,  I  must  touch  on  one  or  two  details,  which 

****"**       have  much  to  do  with  success  hi  these  cases. 

In  the  first  place,  as  we  have  seen,  the  treatment 
of  neurasthenia  proper  and  hysteria  is  fairly  distinct. 
In  the  former,  where  the  whole  mental  system  is 
sound,  and  it  is  the  brain  that  is  worn  out  physically, 
while  rest  is  good,  isolation  is  not  often  needed,  and 
overfeeding  and  massage  can  frequently  be  dispensed 
with.  In  neurasthenia,  moreover,  we  never  fight 
against  the  symptoms  as  we  have  to  do  in  hysterical 


These  latter,  too,  require  isolation,  nearly  always 
some  form  of  Weir-Mitchell  '  cure '  with  massage,  and 


FUNCTIONAL  NERVE  DISEASES         247 

probably  a  large  amount  of  suggestion,  direct  or  in- 
direct, which  neurasthenics  do  not. 

In  mental  cases  rest  in  bed  is  by  no  means  a  R«8tinb«d 
routine  matter,  for  it  nearly  always  aggravates  the  n^did,ay8 
disease.  It  is  also  not  often  of  value,  as  we  have  seen, 
if  the  physique  is  otherwise  good  and  sound,  and  the 
nervous  system  alone  is  overworked  and  weakened  as 
in  neurasthenia.  It  is,  however,  generally  needed  in 
cases  of  malnutrition,  in  diseases  of  neuromimetic 
origin,  and  in  doubtful  nerve  cases,  to  give  time  and 
opportunity  fully  to  determine  the  diagnosis  ;  also  in 
severe  nervous  prostration  even  without  other  phy- 
sical lesions ;  and  in  all  cases  coupled  with  cardiac 
insufficiency. 

Massage  is,  of  course,  always  needed  for  digestive 
purposes  where  there  is  entire  rest  in  bed  to  take  the 
place  of  active  exercise.  Besides  this,  it  is  of  special 
benefit  in  all  disorders  of  the  circulation,  in  all  wasting 
or  weakness  of  muscles,  in  all  stiffness  or  weakness 
of  joints,  in  most  cases  of  pain,  in  congestions  of  ex- 
ternal organs  in  many  forms  of  cardiac  disease. 

The  question  of  friends  and  relatives  is  a  difficult  nor 
one,  and  is  not  answered  by  the  simple  rule  of  com-  isolation, 
plete  isolation.     This  is  invaluable  in  hysterical  cases 
wherever  it  can   be  carried  out  without  too  much 
depression  or  irritation  of  the  patient ;  but  there  are 
many  cases  where  too  rigid  insistence  on  it  means 
failure,  either  from  the  patient  leaving  in  consequence 
or   from   the   bad   results   on   the  nervous  system. 
Here,  as   elsewhere,   success  follows  an  intelligent 
combination  of  flexibility  with  firmness. 

Lastly,  a  word  as  to  'suggestions.'  These,  as 
pointed  out  in  the  previous  chapter,  can  seldom  be 


248  THE  FOECE  OP  MIND 

assimilated  in  a  raw  state,  but  are  readily  taken  in 
combination.  Hypnotism,  however,  is  of  doubtful 
benefit  in  most  neurotic  cases.  Some  patients  of  low 
mental  calibre  are  benefited  by  the  direct  suggestion 
that  they  are  rapidly  getting  well;  more,  however, 
benefit  by  the  use  of  means  directed  to  combat  the 
symptoms  complained  of,  such  as  electricity,  massage, 
drugs,  exercises,  &c.,  which,  besides  doing  a  certain 
amount  of  good  directly,  do  still  more  by  the  sugges- 
tions they  convey  to  the  patient's  mind,  and  thus 
afford  a  rational  prelude  to  an  intelligible  cure.  They 
appeal  to  the  patient's  reason,  or,  at  any  rate,  to  that 
which  passes  under  that  name,  and  afford  satisfactory 
food  to  the  mind,  which  finds  a  gratification  in  the 
use  of  extensive  and  elaborate  means. 

Sngges-  Another  form  of  indirect  suggestion  that  can  only 

indirect.  be  administered  by  a  physician  who  is  in  the  fullest 
confidence  of  his  patient  is  that  which  points  out  the 
evil,  and  the  weakness,  and  the  folly  of  that  character 
of  mind  that  feeds  upon  itself ;  and  that  draws  out 
the  mind  to  altruistic  and  worthy  objects,  and  thereby 
alters  the  flow  of  the  unconscious  current  of  thought, 
which  has  been  feeding  the  disease  all  through ;  and 
thus  makes  the  subconscious  mind  itself  undo  the 
mischief  it  has  done. 

Other  details,  important  enough  to  affect  success, 
are  the  management  of  dyspepsia,  circulation,  sleep- 
lessness, constipation,  restlessness,  depression,  and 
other  troublesome  symptoms. 

£°ouS-          Finally,  in  most  nerve  cases,  to  ensure  a  perma- 

ronndinga.    nency  in  the  cure,  the  patient  should  not  return  to 

the  surroundings  connected  with  his  diseased  state. 

An  effort  should  be  made  to  find  out  his  tastes  as 


FUNCTIONAL  NEEVE  DISEASES         249 

regards  place,  occupation,  sport  and  amusement ;  and 
the  definite  directions  given  (which  should  never  be 
omitted)  as  to  after-life,  for  at  any  rate  some  months, 
should  as  far  as  possible  coincide  with  the  natural 
bent  of  the  patient's  tastes. 

It  may  be  borne  in  mind  that  in  cycling  and  golf 
we  have  now  two  favourite  and  powerful  therapeutic 
agencies. 

For  the  successful  treatment,  then,  of  neurasthenics 
of  all  sorts,  we  need  much  that  might  be  taught  in 
the  schools,  but  is  not,  and  much  that  cannot  be 
taught  in  any  school.  I  consider  that  the  successful 
nerve  doctor  owes  less  to  his  teachers  and  more  to 
his  idiosyncrasy,  experience,  and  applied  common 
sense  than  any  other  variety  of  medical  man. 

Turning  from  my  own  views,  which  I  have  Dr. 
given  at  some  length,  I  find  that  Dr.  Mitchell, 
of  Philadelphia,1  thinks  that  many  of  the  graver 
cases  of  hysteria  and  neurasthenia  which  exhibit 
nervous  instability,  combined  with  physical  weak- 
ness and  with  the  moral  defects  of  hysteria,  react 
well  to  the  rest  cure  when  organic  disease  is  absent. 
From  a  somewhat  extensive  experience  he  sum- 
marises the  methods  of  treatment  adopted  by  him. 
The  most  troublesome  symptoms  are  headache  and 
backache,  tenderness  of  the  spine  and  ovaries,  in- 
somnia, and  chronic  fatigue.  Anaemia,  loss  of 
appetite,  and  emaciation  are  present  in  varying 
degrees.  The  treatment  is  summarised  thus :  (a)  Deuu«  of 
The  patient  is  placed  in  a  private  house  (according  to  to 
means),  and  best  if  away  from  home,  the  room  being 
sunshiny  and  freely  capable  of  ventilation,  (b)  The 

•  Dr.  Mitchell,  Joum.  of  the  Amer.  Med.  Aasoc.  March  9,  1901. 


250  THE  FOECE  OF  MIND 

nurse  should  be,  preferably,  young,  of  agreeable  manner, 
and  a  stranger  to  the  patient.  She  should  never  con- 
verse with  the  patient  about  symptoms  or  treatment. 
She  should  be  able  to  read  aloud,  (c)  Isolation  is 
most  important,  and  the  more  distinctly  hysterical  the 
disease  is  the  more  strict  the  isolation  must  be.  *  No 
letters  are  sent  or  received,  no  visitors  seen,  and  but 
three  or  four  persons  enter  the  room— the  nurse,  the 
physician,  the  masseuse,  and  the  servant.'  (d)  In 
ordinary  cases  six  to  eight  weeks  of  isolation  are  long 
enough,  after  which  a  single  visitor  may  be  allowed. 
Letters  may  then  be  received  or  written  in  the  way' 
of  reward  for  good  conduct.  This  long  isolation  is 
necessary  to  break  up  radically  the  habits  of  long 
invalidism.  (e)  Eest,  at  first  ill  borne  and  irksome, 
is  well  borne  after  a  week.  At  first  feeding  should  be 
done  by  the  nurse,  and  the  patient  over-fed.  All 
voluntary  movements  should  be  forbidden,  except 
sitting  up  for  the  bowels,  &c.  The  circulation  and 
thinking  are  thus  kept  at  a  low  level,  and  one  result 
soon  observed  is  the  improvement  of  the  ability  to 
sleep.  (/)  Diet :  Milk  in  small  quantities  is  given 
every  three  hours,  skimmed,  if  ordinary  milk  is  not 
tolerated.  On  the  fifth  day  of  treatment  a  chop  or 
steak  at  midday  is  given.  From  the  sixth  day  on- 
wards bread  and  butter  and  eggs  are  allowed.  II 
milk  is  badly  borne,  broth  and  jellies  will  give  satis- 
faction, (g)  Massage  :  A  separate  masseuse  is  desir- 
able. Massage  should  begin  on  the  third  day  with 
light  massage  lasting  twenty  minutes,  and  increasing 
daily  to  deep  massage  lasting  one  hour  or  more.  If 
the  patient  is  obese,  long  and  deep  massage  is  good. 
A  second  rubbing  of  the  abdomen  and  spine  by  the 


FUNCTIONAL  NEEVE  DISEASES         251 

nurse  before  sleep  is  helpful.  At  the  end  of  the  first 
week  the  patient  will  begin  to  put  on  weight,  but  if 
this  goes  up  too  fast  massage  is  not  thorough  enough 
and  should  be  increased.  Oil  is  not  necessary  to  aid 
massage,  (h)  Electricity  :  The  slowly  interrupted 
faradic  current  should  be  applied  to  the  '  motor- 
points '  all  over  the  body,  so  as  to  contract  every 
muscle  two  or  three  times.  This  should  be  continued 
for  three  quarters  of  an  hour,  (i)  Constipation  is 
treated  with  aloes  and  strychnine  pills,  and  for 
specially  refractory  cases  hot  injections  of  castor  oil 
per  rectum  may  be  given,  (k)  Insomnia  is  diminished 
by  massage  before  bedtime.  Hypnotics  should  be 
avoided,  and  the  wet  pack  or  abdominal  compresses 
first  tried.  (I)  After  the  first  week  the  patient  is 
allowed  to  sit  up  fifteen  minutes,  the  next  day  twenty 
minutes,  &c.  In  a  fortnight  he  is  allowed  to  walk  in 
the  room  after  passive  movements  of  the  legs  have 
been  carried  out.  Swedish  movements  complete  the 
exercises  and  the  cure. 

This  regime  is  perhaps  as  good  a  one  as  could  be  £JJ^JjJ 
devised,  but  I  do  not  believe  in  any  fixed  routine,  and  bad. 
the  above  has  to  be  widely  varied  in  different  cases. 
You  cannot  set  a  rudder  to  steer  a  ship  across  the 
Atlantic,  nor  can  you  set  with  success  one  fixed  course 
for  all  neurasthenic  patients.    As  a  general  rule,  we 
may  point  out  that  a  neurasthenic  patient  is  often  worse 
by  fighting  symptoms,  and  yet  is  always  willing  to  do 
so;  while  an  hysteric  is  better  by  so  doing,  but  generally 
unwilling. 

The  after-cure  of  neurasthenics  is  always  a  matter 
of  anxiety ;  as  a  broad  rule,  one  may  say  that  the  sea- 
side and  an  altitude  over  2,000  feet  does  not  suit 


252  THE  FOKCE  OF  MIND 

most,  but  a  voyage,  woods,  and  lower  mountain 
slopes  do.  The  pursuit  of  one's  favourite  outdoor 
sport  or  occupation,  with  moderate  cycling,  is  a  good 
general  scheme. 

Prophy-  As  a  prophylaxis  against  incipient  neurasthenia  we 

tana.  may  menf;ion  for  ^omen  a  day's  complete  rest  in  bed ; 
and  for  men  a  week-end  away  from  home,  at  a  good 
inn  in  the  country  or  seaside. 

In  neurasthenia  quite  as  much  as  in  hysteria,  the 
beneficial  influence  of  real  confidence  in  the  doctor  is 
very  marked  ;  and  when  this  is  assured,  the  patient 
makes  rapid  progress  owing  to  its  stimulating  effect 
upon  his  unconscious  mind. 

Conoiu-  The  personal  factor  must  bulk  largely  in  all  cures 

•ion.  Of  functional  nerve  disease,  and  its  value  must  be 
recognised  and  used,  always  with  wisdom  and  care, 
lest  that  which  is  a  valuable  aid  to  health  be  used  as 
a  crutch  to  support  ill-health.  It  is  here  indeed  that 
the  practical  wisdom  of  the  medical  man  comes  in  ; 
for  the  mental  factor  and  influence  may,  like  any  drug, 
be  abused  as  well  as  used,  and  over-doses  may  drug 
or  even  poison  the  patient  as  much  as  opium  or 
chloral.  A  moment's  reflection  indeed  will  show  that 
no  power  so  strong  as  the  '  force  of  mind '  can  be  used 
without  due  care,  and  with  this  hint  we  may  close  these 
few  remarks  on  the  treatment  of  functional  nerve 
disease,  especially  neurasthenia. 


CHAPTER  XV 
THE   THERAPEUTICS  OF  HYSTERIA 

1  In  hysteria  the  cure  lies  in  restoring  the  healthy 
action  of  the  nnconscions  mind.' 

I  HAVE  already  given  various  reasons  for  restricting  Farther 
'Hysteria'  to  one  special  and  well-marked  form  of  tKJt0 
functional  nerve  disease,  by  no  means  very  frequently  J**  of. 
met  with   in   this    country,   and    characterised    by 
narrowed   consciousness   and   seizures.    But  I  also 
pointed  out  that  for  convenience  I  should  under  this 
objectionable  term  '  Hysteria  '  include  every  form  of 
neuromimesis,  a  disease  that  is  much  more  common, 
Bearing  this  enlarged  use  of  the  word  in  mind,  I  will 
very  briefly  recapitulate  one  or  two  points  in  the 
astiology  of  the  disease  before  considering  its  thera- 
peutics. 

Hysteria  in  this  broad  sense  is  a  disease  that 
manifests  itself  either  in  contracted  vision,  anaesthesias, 
exaggerated  emotional  displays  with  fits,  or  in  the 
accurate  but  unconscious  mimicry  of  definite  disease. 
It  will  therefore  be  seen  that  it  is  widely  different 
from  '  nervousness '  (nervoisme)  or  neurasthenia, 
with  its  long  train  of  well-marked  nerve  symptoms 
that  suggest  no  disease  but  the  one  that  is  there.  In 
hysteria  proper— may  we  once  more  repeat?  '—there  is 

1  See  Chaps.  VI.,  VIL,  and  Xffl. 


264  THE  FOECE  OF  MIND 

no  intention  to  deceive  ;  and  it  must  carefully  be 
distinguished  from  malingering  or  shamming,  which 
is  a  direct  attempt  at  fraud,  and  for  which  no  con- 
tempt or  ridicule  can  be  too  severe,  though  of  course 
the  two  may  at  times  co-exist.  The  essential  differ- 
ence that  determines  the  question  of  fraud  is  that  in 
the  former  the  power  that  perfectly  produces  the 
symptoms  of  the  hysterical  disease  is  the  unconscious 
mind,  a  force  of  which  the  sufferer  is  necessarily 
wholly  ignorant.  In  the  latter  the  agent  that 
clumsily  feigns  some  disease  is  the  conscious  mind, 
for  the  action  of  which  the  patient  is  cognisant  and 
responsible,  and  this  constitutes  fraud. 

Cases  of  hysteria  occur  usually  in  an  ill-balanced 
or  starved  brain  ;  so  that,  instead  of  showing  the 
natural  symptoms  of  a  nerve  disease  that  exists,  it 
sets  in  vibration  centres  of  motion  and  sensation  that 
simulate  some  special  disease  suggested  to  the  patient 
unconsciously,  either  through  fear  of  the  disease, 
seeing  the  disease  in  others,  or  it  being  suggested  by 
others  ;  or  possibly  through  some  slight  organic 
disease  having  occurred  in  the  past.  This  may  be 
BO  successfully  done  that  not  only  the  patient  but  the 
doctor  believes  the  lesion  to  be  in  the  body,  whereas 
it  is  in  the  unconscious  mind.  Hysteria  thus  often 
begins  in  some  slight  but  real  disease  in  a  person 
with  an  ill-balanced  or  worn-out  brain  ;  and  this 
slight  but  real  disease  sets  up  a  train  of  associations 
that  produce  a  true  '  hysterical '  disease— that  is,  a 
disease  the  seat  of  which  appears  to  be  in  the  body, 
but  is  really  in  the  brain.  Hysteria  is  most  common 
in  the  spring,  when  the  nervous  system  is  least  well- 
balanced.  It  is  common  in  the  under-  and  over- 


THE  THERAPEUTICS  OF  HYSTEEIA     255 

worked,  in  the  badly  trained  and  imperfectly  educated  ; 
in  boys  from  ten  to  fourteen,  in  girls  from  sixteen  to 
twenty-five,  and  in  spinsters  at  any  age. 

Over-education  and  subsequent  idleness  combined 
are  fertile  causes.     It  is  often  found  in  people  other-  idienesTd 
wise  strong-minded  and  clever.     The  mental  charac-  are  cau8eSi 
teristics  found  in  these  sufferers  are  thus  described 
by  Dr.  Buzzard : 

'Intelligence  good,  apprehension  quick,  memory 
good,  judgment  weak,  no  ability  of  concentration  of 
thought  for  any  length  of  time.  Accuracy  and  perse- 
verance are  deficient.  Emotions  too  easily  excited 
and  incapable  of  control.  The  expression  of  emotion 
is  incongruous ;  tears  at  ridiculous  subjects  and 
laughter  at  tragic.  There  is  great  desire  for  the 
sympathy  and  attention  of  others.  Sometimes  there 
is  exaggeration  in  varying  degree,  which,  however,  is 
probably  a  part  of  the  disease.' 

This  last  point  must  be  noted.     For  while  there  J?JJ«£Mp 
can  be  no  doubt  that  many  of  the  feelings,  such  as  proof  of 
pain,  are  exaggerated,  we  must  remember  on  the  one 
hand  that  they  are  certainly  felt ;  and  that  the  very 
exaggeration  is  a  proof,  not  of  fraud,  but  of  the  ill- 
balanced   working  of   the  judgment  and  perceptive 
powers  of  the  brain. 

We  have  already  given  in  Chapter  VIII.  many 
cases  that  come  under  the  head  of  hysteria,  including 
some  of  paralysis  and  spinal  pains,  which  are  so 
exceedingly  common  that  there  is  no  need  to  give 
further  examples.  Suffice  it  to  say  that  there  is  no 
form  of  paralysis  that  is  not  simulated  by  hysterial 
from  the  loss  of  power  in  a  single  finger  or  joint  to 
the  total  paralysis  of  one  side,  or  of  both  legs,  or  of 


256  THE  FOECE  OF  MIND 

the  entire  body.    The  pain  may  be  in  any  part  of  the 
spine,  but  is  generally  about  the  '  small '  of  the  back. 

In  hysterical  paralysis,  the  muscles,  as  a  rule,  do 
not  waste  much,  and  no  bed-sores  ever  form.  If  the 
helpless  limb  is  bent,  it  often  remains  so  ;  which  it 
would  not  in  true  paralysis. 

This  paralysis  may  also  affect  any  or  all  of  the 
special  senses.  It  may  cause  such  total  loss  of  taste 
for  years  that  the  most  nauseous  substance  can  be 
eaten  without  disgust.  It  may  cause  total  loss  of 
smell,  so  that  neither  garlic,  coal  gas,  asafcetida,  nor 
otto  of  roses  can  be  smelt.  It  may  cause  squint  of 
one  or  both  eyes,  or  colour  blindness,  or  any  sort  of 
imperfect  sight.  It  may  cause  deafness  in  every 
degree.  It  may  cause  loss  of  feeling  or  touch  any- 
where, and  the  part  may  be  pricked  or  cut  without 
being  felt. 

Hysterical  Tumours  of  all  sorts  are  simulated  with  a  fidelity 
that  is  absolutely  startling,  and  skilled  doctors  are 
constantly  being  deceived.  They  may  occur  in  any 
part  of  the  body,  but  are  most  common  in  the  breast 
and  abdomen.  In  the  breast  severe  pain  is  com- 
plained of,  and  a  hard  mass  may  be  felt,  which, 
however,  disappears  if  the  hand  be  laid  flat  upon  the 
part.  Not  so,  however,  with  those  in  the  abdomen. 
I>a^en^s  w^h  these  perverted  nerve  centres  have  an 
unconscious  power  of  either  contracting  part  of  a 
single  abdominal  muscle  so  rigidly  that  it  forms  a 
hard,  round,  solid  swelling,  plainly  perceptible ;  or 
they  can  spasmodically  contract  the  digestive  canal 
at  two  points  so  as  to  imprison  between  them  a 
largely  distended  portion  which,  being  filled  with 
flatus  and  partly  movable  and  easily  felt  in  the  ab- 


THE  THEEAPEUTICS  OF  HYSTEEIA     257 

dominal  cavity,  is  exactly  like  an  abdominal  tumour. 
If  the  person  be  thin  and  the  tumour  be  pressed  down 
or  resting  on  the  abdominal  aorta,  the  pulsations  from 
the  blood-vessel  are  so  perfectly  communicated  to  the 
false  tumour  that  it  is  believed  to  be  an  aneurism.  I 
was  told  by  one  of  our  best  known  physicians  that  fifty 
cases  had  been  sent  in  to  the  hospital  of  this  form  of 
pulsating  tumour,  as  abdominal  aneurism ;  all  of  them, 
previous  to  admission,  having  been  examined  and 
certified  to  be  such  by  medical  men  ;  and  yet,  on  fur- 
ther examination,  every  one  of  them  turned  out  to  be 
of  hysterical,  and  not  local,  origin.  The  only  way  in 
which  they  can,  in  many  cases,  be  found  out,  is  by 
anaesthetising  the  patient,  when  the  tumour  generally 
disappears,  but,  of  course,  returns  immediately  the 
patient  regains  consciousness.1  I  remember  in  hos- 
pital practice  one  special  case  of  this  sort  under 
my  care  of  a  woman  whose  whole  abdomen  was 
greatly  distended  by  a  supposed  tumour  of  enormous 
size.  Under  chloroform  it  at  once  disappeared,  but 
on  regaining  consciousness  there  it  was  as  large  as 
ever.  The  woman  was  not,  therefore,  '  cured,'  and  it 
was  no  comfort  to  her  to  know  that  when  she  was  un- 
conscious the  swelling  was  not  there ;  all  she  wished 
was  to  be  relieved  of  it.  I  therefore  put  her  under  HOW  cored 
chloroform  again,  and,  while  unconscious,  tightly 
bound  her  round  with  plaster-of -Paris  bandages  that 
I  allowed  to  set  as  hard  as  stone  before  she  regained 
consciousness.  This  time,  of  course,  she  could  not 
expand,  and  the  'tumour'  was  gone.  She  was 
delighted  we  had  'removed'  it;  and  after  keeping 

1  I   have    already    mentioned    these    remarkable    tumours    in 
Chapter  VHI. 

s  2 


258  THE  FOECE  OF  MIND 

the  bandage  on  three  weeks,  it  was  taken  off,  and  the 
woman  left,  most  thankful  to  be  relieved  of  her 
distressing  complaint. 

Hysterical  A  young  lady  tottered  into  the  out-patient  depart- 
ment  of  one  of  our  large  London  hospitals  not  long 
since,  followed  by  her  mother  in  an  agony  of  mind, 
having  an  open  tin  of  '  Brand's  '  in  one  hand  and  a 
spoon  in  the  other.  She  had  brought  this  because 
her  daughter  was  dying  from  a  contraction  of  the 
gullet,  and  she  wished  to  show  us  that  not  even  a 
little  jelly  could  be  swallowed.  The  girl  was  reduced 
to  a  skeleton,  and  would  certainly  have  died  from 
neuromimesis  if  not  relieved,  for  there  can  be  no 
doubt  that  people  die  solely  from  hysterical  affec- 
tions, though  some  may  question  it.  After  using 
appropriate  means  to  affect  the  mind  indirectly,  in 
about  half  an  hour  the  patient  was  sitting  in  one  of 
the  wards  eating  a  large  plateful  of  boiled  mutton, 
potatoes,  and  turnips,  with  '  hospital  pudding '  to 
follow.  It  is  cases  like  these,  seen  by  men  wholly 
ignorant  of  the  powers,  and  perhaps  of  the  existence, 
of  the  unconscious  mind,  that  are  necessarily  con- 
sidered fraudulent  and  the  patients  '  malingerers.' 

Hysterical          A  matron  of  an  important  institution  had  to  resign 

aphonia.  her  p0st  an(j  &  jarge  Baiarv  through  total  loss  of  voice. 
Examination  showed  that  this  was  hysterical,  for 
when  she  coughed  she  phonated,  and  the  vocal  cords 
were  perfect  in  action.  Appropriate  means  in  a  fort- 
night completely  restored  the  lost  voice. 

Hysterical  Hysterical  vomiting  is  very  common,  and  often 
persists  for  months  ;  the  patient,  however,  does  not 
lose  as  much  weight  as  would  be  expected.  The 
appetite  may  be  greatly  perverted ;  it  may  be  enor- 


THE  THEEAPEUTICS  OF  HTSTEEIA     259 

mous,  or  entirely  absent,  or  depraved,  all  sorts  of 
things  being  swallowed.  Symptoms  of  obscure  dis- 
eases, such  as  hardenings  or  softenings  of  the  spinal 
cord,  that  could  not  be  known  consciously  to  the 
patient,  and  consisting  of  tremors,  rigidity,  spasms 
&c.  in  special  parts  of  the  body,  are  produced  by 
hysteria,  and  may  persist  for  months ;  and  only 
slight  inconsistencies  reveal  that  they  are  hysterical 
after  all.  But  I  must  not  dwell  further  on  what  has  Those 
already  been  enlarged  upon  in  a  previous  chapter,  JJJJJu, 
only  repeating  that  on  thinking  over  even  these  few  fraudulent 
cases  it  will  be  felt  how  readily  the  idea  of  deception 
comes  to  the  mind.  It  is  only  when  the  real  aetiology 
of  the  disease  is  grasped  that  such  an  idea  is  seen 
to  be  inadmissible.  I  will  now  pass  on  to  indicate 
a  few  principles  in  therapeutics. 

The  first  thing  obviously  in  the  cure  of  advanced  First  point 
hysterical  disease  is  to  remake,  as  far  as  possible,  the 
vitiated  body  and  brain  with  fresh  flesh  and  blood 
and  nerve  ;  and  then,  when  we  have  put  the  patient 
into  the  best  possible  bodily  health,  we  shall  have 
cured  the  physical  cause  of  the  nerve  disorder  at  any 
rate.  Then,  or  even  simultaneously,  the  unconscious 
mind  must  be  made  through  consciousness,  de- 
liberately, scientifically,  and  systematically,  to  undo 
the  evil  it  has  done,  and  substitute  good  habits  of 
thought  and  action  for  bad.  This  is  done  with 
varying  success  according  to  the  skill  of  the  operator. 
When  the  mind  (conscious)  is  not  sound,  it  is  of  course  Congciotn 
impossible.  We  find  that  with  the  insane,  exhortation,  bT«>un<L§ 
argument,  repression,  and  agreement  are  all  about 
equally  bad  ;  and  the  only  relief  is  by  diverting  the 
mind  on  to  indifferent  subjects  ;  in  other  words,  trying, 


260 


THE  FORCE  OF  MIND 


Rational 
ideas  based 
on  realities. 


Irrational 
ideas  on 
unrealities 


Value  of 
true  reli- 
gion; evil 
of  false. 


by  resting  it,  to  enable  it  to  recuperate.  This  and  steady 
employment  give  the  best  results.  With  hysterical 
patients,  where  it  is  the  unconscious  mind  that  is 
affected,  the  conscious  mind  is,  as  a  rule,  sound,  and  the 
case  is  different.  We  must  remember  that  rational 
ideas  are  based  on  realities,  irrational  on  unrealities  ; 
therefore  when  the  appearance  of  reality  can  be 
removed  from  the  idea,  the  patient  (with  a  sound 
mind)  will  perceive  it  is  irrational. 

For  example,  in  loss  of  voice,  a  patient  made  to 
shout  by  means  of  an  electric  battery  can  be  shown 
she  has  no  true  aphonia,  and  thus  cured  through  the 
removal  of  the  appearance  of  reality  from  her  '  irra- 
tional '  ideas.  We  must  of  course  first  look  at  the  case 
from  the  hysterical  patient's  point  of  view  to  convert 
her  to  ours.  And  our  success  in  the  latter  will  be 
entirely  dependent  on  the  perfection  with  which  we 
accomplish  the  former.  The  constant  and  steady 
pressure  of  truth  must  be  kept  up  on  the  mind,  till 
the  unconscious  mind  has  been  made  to  undo  the 
evil  it  has  done. 

The  delusions  of  hysteria  are  therefore  best  re- 
moved by  demonstrating  them  to  be  irrational — first 
by  means  that  prove  the  supposed  disease  no  longer 
exists  ;  and  then  by  argument  based  on  these  success- 
ful means. 

I  must  not  omit  here  one  word  about  religion. 
While  it  is  true  that  the  morbidness  and  over-intro- 
spection that  accompany  various  sorts  of  fanaticism 
form  one  of  the  greatest  emotional  causes  of  hysteria; 
on  the  other  hand,  true  Christianity  in  its  Divine  sim- 
plicity as  taught  by  its  Founder  is  most  beneficial  to 
the  mind.  Dr.  Ormerod  may  be  quoted  here.  He 


THE  THEEAPEUTICS  OF  HYSTEEIA     261 

says :  '  Few  things  are  more  opposed  to  hysteria  than 
the  trustful,  patient,  altruistic  spirit  inculcated  by 
Christ ;  and  few  things  more  conducive  to  it  than  the 
excitement  seen  in  revivals,  or  the  mysticism  or  self- 
conceit  which  sometimes  poses  as  religion.' 

As  in  all  else,  it  is  the  true  that  helps,  the  imita- 
tion only  harms. 

To  return  to  general  therapeutics  in  hysteria,  we  General 
get  the  following  interesting  account  of  procedure  peutLjof 
from  Dr.  Gibson : l  '  As  hysteria  is  a  disorder  due  to  h**"™' 
nerve  instability,  no  method  of  treatment  can  have 
the  slightest  success  unless  it  be  believed  in  by  the 
patient,  whether  the  case  be  treated  by  the  placebo 
method,  or  by  the  application  of  complicated  pro- 
cedures. .  .  .  One  object,  and  one  only,  is  sought  for, 
namely,  a  cure,  by  suggestion  to  the  trustful  patient 
that  this  will  result  from  the  treatment  adopted. 
Undoubtedly  many  of  the  methods  successfully 
applied  by  eminent  physicians  savour  strongly  of 
charlatanism  ;  but  the  fault,  if  fault  it  be,  lies  rather 
in  the  nature  of  the  disorder  than  at  the  door  of  the 
physician.'  The  latter  part  of  this  is  interesting,  for 
it  shows  that  in  1901  the  bold  quack  of  Sir  James  1901  and 

1RAA 

Paget's  letter  of  1866,  quoted  in  Chapter  I.,  is  no 
longer  able  to  work  his  wicked  will  on   attractive 
patients  while  their  physicians  stand  by  with  hands 
folded  in  impotence.     Though    some    methods  are  who  is  the 
described  as  strongly  'savouring of  charlatanism,'  the  'iaack'? 
physician  is  learning  at  last,  tentatively,  timorously, 
to  trust  and  respect  the  mental  factor  in  medicine ; 
and  we  think  the  resemblance  to  the  quack  is  purely 
superficial,  if  it  exists  at  all.    Indeed,  were  it  not 

1  Dr.  Gibson  (Edinburgh),  Text-book  of  Medicine,  1901. 


262  THE  FOECE  OF  MIND 

savouring  of  irreverence,  I  would  venture  to  sug- 
gest if  the  real  quack  may  not  be  rather  he  who 
pretends  to  treat  diseases  dependent  on  a  mental 
factor  solely  by  drugs  and  draughts  that  cannot  pos- 
sibly cure. 

sir  Felix  I   should  like  to  quote  here  a  recent  utterance 

FT^b^'   of  Sir  Felix  Semon's  upon  mental  medicine. 

He  says,1  speaking  of  the  treatment  of  the  upper 
air  passage,  that  the  doctor  must  consider  '  whether 
he  will  flatter  the  patient's  whims  by  giving  him  an 
innocent  local  placebo  in  addition  to  the  constitu- 
tional treatment  which  is  obviously  indicated.  There 
is  undoubtedly  something  to  be  said  in  favour  of  the 
latter  alternative.  As  Dr.  Goodhart  truly  remarks  : 
"  There  are  times  when  the  sick  are  not  reasonable 
beings,  and  unless  they  have  a  bottle  of  medicine  " — 
or  shall  we  in  our  special  case  say  a  gargle,  or  a 
paint,  or  an  inhalation  ?— "  to  anchor  their  faith  to 
(oh,  shifting  sands  !),  they  are  in  a  state  of  unrest  that 
is  positively  harmful  to  their  progress."  That  is 
certainly  true.  And,  further,  when  with  a  little 
knowledge  of  the  world,  and  with  plenty  of  previous 
experiences  to  guide  one,  one  sees  that  the  patient, 
disappointed  at  not  getting  what  he  wants,  thinks : 
"That  doctor  does  not  understand  my  complaint," 
and  that  he  is  sure  to  fall  into  the  hands  of  the 
topical  enthusiast,  or  of  somebody  worse,  who  will  be 
equally  sure  to  mulct  him  in  a  perfectly  unnecessary 
operation,  one  is  confronted  by  the  difficult  question 
whether  in  the  patient's  own  interest  it  would  not 
have  been  better  to  comply  with  his  wish  and  to  give 
him  something  local  which,  if  absolutely  useless, 

1  Sir  Felix  Semon,  British  Medical  Journal,  November  2, 1901. 


THE  THEEAPEUTICS  OP  HYSTEEIA     263 

would  have  been  at  any  rate  equally  harmless,  and 
would  have  set  his  mind  at  rest.  I  dare  not  say  that 
this  "  pia  fraus "  must  never  be  practised.  But 
against  it  are  three  very  grave  reasons,  which  I 
would  particularly  recommend  to  your  consideration. 
In  the  first  place,  when  prescribing  some  local 
application,  which,  of  course,  has  to  be  repeated  at 
stated  intervals,  you  involuntarily  become  the  patient's 
accomplice  by  concentrating  his  mind  on  his  local 
sensations,  whilst  in  his  own  interest  you  ought  by 
all  possible  means  to  divert  it  from  them.  Secondly, 
you  lend  yourself  to  supporting  the  general  notion, 
which  you  know  is  neither  correct  nor  desirable — 
namely,  that  all  affections  of  the  upper  air  passages 
ought  to  be  treated  locally.  And,  thirdly,  and  most 
serious  of  all,  by  yielding  to  the  temptation  you  may 
unconsciously,  and  with  the  best  intentions  in  the 
world,  yet  very  actually,  transgress  the  line  between 
legitimate  practice  and  quackery.  Under  all  circum- 
stances, therefore,  the  pious  deception  of  which  I  have 
just  spoken  ought  to  be  practised  only  in  the  rarest 
of  cases,  and  the  doctor  ought  to  stiffen  his  back  and 
harden  his  heart  against  meekly  complying  with 
every  unreasonable  wish  expressed  by  an  unreasonable 
patient.  Better,  I  think,  to  lose  such  a  one  if  he  will 
not  listen  to  well-meant  advice,  than  to  have  to  con- 
fess to  yourself  that  you  have  descended  to  the  level 
of  habitually  acting  against  your  own  better  convic- 
tion.' 

On  this  I  would  say  that  I  doubt  very  much  if  a 
'  placebo '  is  ever  '  absolutely  useless  ; '  even  Sir  Felix 
allows  '  it  would  set  his  mind  at  rest,'  which  is  surely 
.of  some  use.  But  the  third  point  is  the  one  of 


264  THE  FOECE  OF  MIND 

importance,  and  I  think  Sir  F.  Semon  a  little 
misses  the  point  when  he  makes  it  turn  on  the 
keeping  or  losing  of  the  patient.  To  me  the  point  rather 
is,  whether  the  mind  of  the  patient  is  to  be  enlisted 
as  a  legitimate  and  powerful  adjuvant  to  the  cure  or 
not,  by  means  of  this  '  placebo.'  To  give  a  '  placebo ' 
to  retain  a  patient  who  would  otherwise  be  lost  is 
most  unworthy  practice ;  to  give  one  because  by  this 
means  the  cure  can  be  really  hastened  is  right,  and 
consistent  with  the  highest  ethics. 

Amongst  the  means  used  we  may  mention  besides 
direct  mental  influence  the  value,  largely  psychic, 
of  drugs,  climate,  isolation,  forced  feeding,  baths,  elec- 
tricity, minor  operative  measures,  massage,  dietaries, 
special  occupations,  changes  of  scene  and  country, 
hard  work,  moderate  shocks,  mental  or  physical, 
emotional  incentives,  object-lessons  in  others,  and 
Form  fresh  religion.  The  point  generally  is  to  form  fresh  idea 
ide*  paths,  pj^jj^  causmg  disuse  of  the  old  ruts  in  the  brain; 
by  making  suggestions  opposed  to  the  vicious  trains 
of  thought  throughout  the  day  by  every  means  at 
one's  disposal,  and  by  securing  sound  sleep,  if  neces- 
sary by  drugs,  or  by  a  full  warm  meal  last  thing  at 
night. 

Herman  suggests l '  the  occupation  of  the  patient's 
mind  by  massage  and  electricity  (as  adjuvants).  The 
mystery  of  electricity  satisfies  the  patient  that  some- 
thing powerful  is  being  done,  and  gives  her  confi- 
dence.' I  may  add  that,  besides  this  psychic  effect, 
it  does  much  good  physically. 

Hypnotism  is  by  no  means  specially  suited  for 
hysterical  cases.  Ernest  Hart,  who  collected  much 
1  Dr.  G.  Herman,  Diseases  of  Women,  p.  25. 


THE  THEEAPEUTICS  OF  HYSTERIA     265 

information  at  the  Salpetriere,  writes : !  '  Charcot, 
Eichet,  Babinski,  and  others  have  concluded  that  for 
curative  purposes  hypnotism  is  very  rarely  useful, 
generally  entirely  useless,  and  often  injurious.' 

As  a  matter  of  fact,  useful  therapeutical  sugges-  !>at  better 
tions  can  perfectly  well  be  made  naturally  without 
hypnotism.  At  present  its  use  is  perhaps  greatest  in 
affording  a  unique  means  for  investigating  obscure 
psychic  phenomena.  In  this  direction  it  is  far  more 
successful  than  in  therapeutics. 

I  will  now  conclude  this  chapter  with  a  few  notes 
on  special  cases. 

In  hysterical   paraplegia,  Dr.  Buzzard  points  out  Treatment 
that  '  the  kind  of  treatment  is  of  little  consequence,  !£i  parJ1" 
so  that  it  is  profoundly  impressive  '  (hereby  showing  plegia- 
that  its  value   is   psychic).     'In   the   suggestion   of 
paralysis  we  get  a  depressed  asthenic  emotional  state 
ending  in  the  paralysis ;  in  the  cure  we  require  a  sthenic 
state,  and  the  exaltation  of  all  the  vital  powers.' 

Many  cases  Buzzard  has  observed  of  supposed 
hysterical  paraplegia  are  combined  with  paresis  of 
the  ilio-psoas  muscle,  so  that  the  knee  cannot  be 
lifted  well,  as  in  placing  the  foot  on  a  chair, 
suggesting  a  possible  organic  complication  in  disease 
of  the  spinal  cord  at  the  level  of  the  first  lumbar 
segment.  In  hysterical  paraplegia  we  notice  that 
while  there  is  a  total  absence  of  gross  movement, 
which  the  patient  thinks  important,  there  is  often  a 
completely  retained  power  of  minor  movements.  In 
sound  mental  cases,  if  this  is  carefully  demonstrated 
to  the  patient,  it  may  effect  a  cure  by  removing  the 
basis  for  the  irrational  idea  ;  for  the  muscular  action 

1  Ernest  Hart,  Hypnotism,  p.  68. 


266  THE  FOBCE  OF  MIND 

of  the  gross  movements  in  the  legs   is   blocked  or 
inhibited  solely  by  ideas. 

Pure  '  The  Lancet '  records  T  a  case  of  Dr.  Barkas  of  a 

the^  woman  (58)  with  supposed  disease  of  every  organ, 
peutics.  w-tj1  paing  everywhere,  who  had  tried  every  method 
of  cure,  but  was  at  last  experimentally  cured  by  men- 
tal therapeutics  pure  and  simple.  Assured  that 
death  would  result  from  her  state,  and  that  a  certain 
medicine  would  infallibly  cure  her,  providing  it  was 
administered  by  an  experienced  nurse,  one  table- 
spoonful  of  pure  distilled  water  was  given  her  at  7, 
12,  5,  and  10,  to  the  second  with  scrupulous  care ; 
and  in  less  than  three  weeks  all  pain  ceased,  all 
diseases  were  cured,  and  remained  so.  This  is  a 
valuable  experiment  as  excluding  every  material 
remedy  whatever,  and  proving  that  it  is  the  mental 
factor  alone  that  cures,  however  it  may  be  generally 
associated  with  material  remedies.  This  incidentally 
gives  another  illustration  of  the  therapeutic  power  of 
the  clock,  spoken  of  in  Chapter  XII. 

Value  of  Dr.  Morrison,  of  Edinburgh,  discovered   that  a 

B^emOE  lady  who  had  constant  violent  hysterical  attacks  had 
given  her  hand  to  one  man  and  her  heart  to 
another.  A  little  direct  common-sense  talk  in  this 
case  formed  an  agreeable  substitute  for  the  distilled 
water  in  the  other,  and  the  patient  never  had 
another  attack. 

In  the  days  of  the  tractors,  attention  was  drawn  to 
the  part,  which  was  lightly  touched  or  stroked  with 
metal  or  wood,  with  invariable  good  results,  as  long 
as  the  faith  lasted  in  the  process. 

In  hysterical  retention  an  aperient,  with  direction 

1  The  Lancet,  1894  iL  1246. 


THE  THERAPEUTICS  OF  HYSTERIA     267 

to  the  patient  to  hold  her  water  as  long  as  she  can,  cure  of 
will  often  produce  uresis  when  the  bowels  act.  SuSS? 

Dr.  Dale  tells  us  of  the  wife  of  a  medical  man  Failure  of 
with  hysterical  paralysis  of  her  legs.     She  was  told  it  JJJ8^8 
was  due  to  her  mind,  and  to  overcome  it  by  force  of  ce89  °.f  an 
will  (a  futile  suggestion) ;  she  could  not,  and  went  mbT0™ 
about   in  a  Bath  chair.      One   summer   a   drunken 
Highlander   tried  to  kiss  her ;    she  jumped  up  and 
ran  off,  cured,  for  her  husband.     Here  we  see  most 
instructively  the  impotence  of  the  conscious  will  power, 
and  the  force  of  the  unconscious  mind  the  moment 
there  is  a  suggestion  strong  enough  to  reach  it. 

Hysteria  may,  as  I  have  said,  mask  organic 
disease.  Dr.  Sutton  speaks  of  a  lady  who  was  seven 
years  on  her  back  with  pain  in  her  spine,  and  was 
pronounced  hysterical  by  two  great  authorities,  and 
made  to  get  up.  She  died  of  cancer  of  the  lung  a 
few  days  after  in  her  carriage. 

Another  case  within  my  knowledge  was  vigorously 
treated,  by  forced  movements  causing  intolerable  pain, 
for  hysterical  hip  disease  by  a  skilled  surgeon,  until 
the  Rontgen  rays  revealed  a  dislocated  femur. 

Sometimes  total  neglect  of  the  affected  parts  is  Treatment 
best,  and  I  may  conclude  these  few  observations  with  • 
a  case  of  my  own  that  illustrates  this.  I  have 
already  alluded  to  it  briefly,  but  will  now  give  a  few 
details.  A  girl  aged  sixteen  was  brought  to  me  with 
strong  left  convergent  strabismus  and  diplopia  and 
slight  ptosis,  with  total  bilateral  loss  of  taste  and 
smell  for  years,  proved  to  be  complete  by  careful 
experiment,  with  deafness  (watch  not  heard  at  three 
inches  from  either  ear),  and  strong  spastic  contraction 
of  the  left  arm  and  hand,  proceeding  to  rigidity  and 


268  THE  FOBCB  OF  MIND 

wasting  of  some  months'  standing,  and  some  stiffening 
of  the  left  hip-joint.  This  girl  had  had  for  months 
every  possible  ocular  and  general  treatment,  including 
massage,  with  absolutely  no  improvement  of  any 
Bymptom,  the  arm  especially  becoming  more  and 
more  rigid.  When  she  came  under  my  care  I 
observed  this,  and  at  once  pointed  out  to  the  patient 
the  infallible  irritation  that  must  be  set  up  in  the 
diseased  parts  by  any  manipulation,  and  forbad  them 
to  be  touched,  assuring  her  that  the  strong  manipula- 
tion of  the  sound  side  would  cure  the  diseased  one, 
and  asked  her  carefully  to  observe  the  process,  which 
was  extended,  as  occasion  required,  to  all  the  affected 
With  core  special  senses.  It  was  beautiful  to  see  the  symptoms 
disappearing  one  after  another  under  this  treatment, 
till  at  last  the  girl  threw  away  eight  pairs  of  eye- 
glasses with  which  she  had  been  provided  by  ophthal- 
mic surgeons,  together  with  her  splints  and  other 
apparatus,  and  went  home  with  her  limbs  and  joints 
restored  both  in  movement  and  nutrition,  with  perfect 
reason,  acute  hearing,  and  restored  taste  and  smell ; 
and  shortly  afterwards  was  happily  married — cured 
entirely  from  first  to  last  by  forcing  the  unconscious 
mind,  through  the  rational  action  of  the  conscious 
mind,  to  undo  all  the  evil  and  misery  it  had  caused 
this  girl  for  many  years. 

It  will  be  observed  that,  though  this  chapter  is 
headed  '  The  Therapeutics  of  Hysteria,'  no  details  of 
any  fixed  system  of  cure  are  given.  And  this  is  for  a 
very  definite  reason,  already  stated  when  speaking  of 
neurasthenia. 

The  intricacies  of  the  action  of  the  unconscious  mind 
upon  the  body  in  this  disease  are  so  complex  that  each 


THE  THEEAPEUTICS  OF  HYSTEEIA      269 

case  must  be  separately  treated  on  its  merits,  though 
the  whole  maybe  grouped  under  the  unsatisfactory  title 
of '  hysteria.'  All  cures  emphatically  must  be  hand- 
made here.  Cast-iron  routine  ends  in  disaster,  and 
original  and  new  methods  have  constantly  to  be 
employed.  For  this  reason,  then,  all  we  can  do  is  to 
state  broad  principles,  leaving  details  to  be  added  in 
each  individual  case. 

The  principles  of  cure,  however,  are  fairly  clear 
if  the  cause  be  understood  ;  and,  however  varied  the 
cases,  I  trust  enough  has  been  said  to  establish  the 
thesis  at  the  head  of  the  chapter  that  '  in  hysteria 
the  cure  lies  in  restoring  the  healthy  action  of  the 
unconscious  mind.' 


270  THE  FOBCE  OF  MIND 


CHAPTER  XVI 
TEE  PEACTIGAL   CONCLUSION 

1  The  neglect  of  the  mental  factor  in  medicine  is  a 
source  of  weakness  to  the  profession  which  should  at 
once  be  removed.' 

Manner  M  ^' SHORT  time  ago  I  was  calling  at  a  patient's  house, 
disease.  and  while  waiting  to  see  her  entered  hi  to  conversa- 
tion with  her  eldest  son.  He  had  on  his  part  many 
questions  to  ask  me  bearing  on  his  own  state  of  health, 
and  the  eager  nervous  way  with  which  they  were  put, 
as  well  as  their  nature,  showed  me  I  had  to  do  with 
a  case  of  hypochondria  hi  a  fine  young  sportsman  of 
twenty-five.  I  spoke  to  his  mother  a  few  days  after- 
wards as  to  what  I  feared  was  the  young  man's  condition, 
and  she  told  me  that  it  all  dated  from  several  visits  he 
had  paid  to  a  physician  for  some  local  ailment.  This 
doctor,  a  clever  good  man,  well  known  to  me,  is  him- 
self an  invalid,  and  has  frequently  to  use  medicines 
or  lotions  hi  consulting  hours  for  his  own  relief.  He 
has  also  a  very  depressing  nervous  manner  and  an 
anxious  desponding  look,  and  told  the  young  man  as  he 
shook  his  head  it  would  be  a  long  time  before  he 
would  be  right.  A  few  visits  of  this  sort  started  the 
practice  of  morbid  introspection,  which  the  young 
fellow  had  been  pursuing  since. 


THE  PEACTICAL  CONCLUSION          271 

Not  far  from  him  another  doctor  lives  of  a  different  Manner  M 
type,  also  known  to  me.     The  sister  of  a  patient  of  disease!0' 
mine  has  been  under  his  care  for  a  short  tune,  and 
she  writes  as  follows  in  a  letter  I  was  permitted  to  see : 

'I  often  think  of  him  and  his  kindness  to  me 
through  those  long  weary  weeks — not  only  what  he 
did,  but  what  he  was.  Some  people  help  one  more 
than  they  know  by  just  being  themselves  ;  I  mean  by 
their  own  living  personality.  Don't  you  agree  with 
me  ?  A  bright  smile  on  a  dark  day  takes  so  much  of 
the  darkness  away  !  Oh  !  it  is  the  little  things  that 
mean  so  much — the  small  things  that  are  so  great ! ' 

Here,  then,  are  sketches  from  life  of  two  equally 
estimable  men ;  of  the  two,  the  former  is  probably 
the  abler  doctor,  and  holds  the  higher  position 
amongst  his  medical  colleagues. 

And  yet,  how  little  he  knows  and  understands  of  sins  of 
the  evil  he  does  so  unconsciously,  so  ignorantly  :  for  lg 
this  young  man  was  no  solitary  case  ! 

I  ask  in  all  earnestness  and  all  seriousness,  is  it 
right,  is  it  scientific,  is  it  fair  that  this  honourable  man 
should  have  gone  laboriously  through  college  and 
hospital,  sick  ward  and  lecture  theatre,  and  learned 
all  that  the  medical  science  of  the  latter  half  of  the 
nineteenth  century  could  teach  him,  and  yet  be  left 
in  such  utter  ignorance  of  psycho-therapy,  of  the 
effect  of  manner  on  mind  ? 

These  two  instances  could   be  multiplied,  alas !  Pr^aoe 
indefinitely ;  but  the  list  of  victims  of  this  systematised  ™ctmiB. 
ignorance  will  never  be  made  out,  and  the  evil  all 
unconsciously  done  never  be  known. 

It  is  quite  futile  to  urge  that  men  have  their  idiosyn- 
crasies,  and  can  never  be  all  alike.  This  is  of  course  differ. 


272  THE  FOECE  OF  MIND 

true,  but  is  beside  the  mark  ;  and  is  no  reason  what- 
ever for  keeping  from  them  the  knowledge  of  the 
therapeutic  value  of  manner  and  personality, 
but  need  One  might  as  well  refuse  to  teach  physical  dia- 

fare'be™"    g1108*8  because  all  men  are  not  equally  good  observers, 
ignorant.     Or  surgery  because  manual  skill  varies  so  much,  as  to 
leave  in  neglect  the  science  of  mental  therapeutics 
because  all  cannot  use  it  with  the  same  effect. 

The  argument  defeats  itself,  for  if  all  naturally 
practised  it  unconsciously,  there  would  be  less  need 
for  teaching  it ;  and  it  is  just  because  all  men  are 
not  alike,  that  scientific  instruction  should  be  given 
in  the  power  for  good  or  evil  that  resides  in  the  doctor 
himself,  alike  in  causing,  aggravating,  and  curing 


Reason  for  Let  me  here  be  clearly  understood.  I  am  advocat- 
wntmgtiis  jng  ^Q  Sys^em  Of  mentai  therapeutics.  I  hold  no  brief 
for  any  of  the  numberless  mind  curers,  mental  healers, 
Christian  Scientists,  or  other  American  soothsayers. 
I  am  not  a  hypnotist  or  a  faith-healer,  nor  am  I 
interested  in  anything  professionally  but  the  legitimate 
practice  of  medicine,  as  medicine — free  from  all  dis- 
tinguishing labels ;  I  am  therefore  running  no  fad,  no 
cure,  and  have  no  aim  whatever  in  writing  this  book 
save  to  get  my  colleagues  seriously  and  earnestly  to 
consider  whether  it  is  not  their  bounden  duty  as 
honest  men  to  study  and  seek  to  understand  every 
great  power  concerned  in  the  cause  and  cure  of 
disease. 

Knowledge        It  is  not  that  their  practice  or  their  prescriptions 
"  P™"-     have  to  be  radically  altered  ;  it  is  not  that  their  text- 
books are  to  be  cast  aside  ;  but  it  is  that  everywhere 
and  at  all  times  they  shall  have  constantly  before  them 


THE  PRACTICAL  CONCLUSION  273 

the  two  questions:  'What  part  does  mind  play  in 
causing  this  disease  ? '  and  '  How  can  it  be  made  to 
assist  in  its  cure  ? ' 

With  this  of  course  goes  a  knowledge  and  sense  of 
the  value  of  their  own  personality,  and  how  to  use  it 
for  good  and  not  for  evil. 

The  point  to  be  decided  is  whether  the  force  of  i«  ti»e 
mind  in  disease  is  a  real  and  important  subject  for  pr^tfcai* 
study — whether    it    is    one  of    practical    value    to  Talue? 
medical   men.     I  think  I  have  said  enough,  and 
quoted  enough,  to  show  that  the  opinion  of  a  large 
number  in   the  profession  who  are  worthy  of  our 
highest  respect  agrees   that  it  is.    It  is  a  subject 
alluded  to  everywhere,  and  taught  nowhere ;  and  no 
single  day  passes  in  a  medical  man's  life  but  he  and 
his  patients  must  suffer  consciously  or  unconsciously 
from  his  ignorance  of  it.     Is  it,  then,  a  subject  that  ^  **£• 
could  be    taught  with  advantage  in  our  schools? 
Emphatically,  yes ;  and  one  too  which,  if  properly 
taught,  would  be  found  of  absorbing  interest. 

In  the  causation  of  disease,  if  not  the  greatest,  it 
is  at  any  rate  the  most  universal  factor. 

What  an  untrodden  field  lies  open  in  the  trained 
observation  of  the  part  it  plays  in  aetiology ! 

Clinically  how  interesting  to  observe  in  the  wards  An  ™-Q 
how  much  of  each  disease  is  due  to  the  mental  factor  !  aTia  S 

The  part  the  mind  plays  in  sickness— in  different  j£teeare.t 
classes,  in  the  two  sexes,  at  different  ages,  in  different 
occupations,  and  in  the  different  groups  of  disease — 
might  all  be  worked  out;  for  the  whole  subject  is 
practically  virgin  soil,  and  those  who  pursue  this 
study  are  really  explorers  in  an  untrodden  country. 
Lectures  might  be  given,  as  facts  are  accumulated, 

*l 


274  THE  FOECE  OF  MIND 

New  taxi-  Text-books  would  appear,  of  a  novel  type,  giving 
book8'  scientifically  a  whole  body  of  facts  bearing  on  disease 
not  to  be  found  in  any  of  our  standard  works  at 
present ;  and  psychological  medicine  would  no  longer 
be  confined  to  questions  of  lunacy,  but  would  embrace 
the  interesting  study  of  the  relations  of  the  sound 
mind  to  the  diseased  body. 

If  we  turn  from  cause  to  cure,  the  subject  widens, 
and  the  interest  is  intensified. 

The 'on.  When  once  the  matter  is  fairly  studied  clinically 

riSr?     and  scientifically,  the  first  point  that  is  pressed  home 
healer*1      uP°n  the  consciousness  is,  how  little,  after  all,  the 
doctor  does;  and  how  much  Nature,  or  better  the 
vis  medicatrix  natures,  or  best  of  all  the  'uncon- 
scious mind,'  effects  in  all  cures. 

No  recovery  is  possible  without  this  agency.  It 
is  absolutely  indispensable  to  the  patient's  cure, 
and  this  can  be  said  of  no  other  therapeutic  agent 
whatever. 

The  con-  JQ  contrast  with  its  wondrous  force  how  small  and 

mind  has     limited  are  the  powers  of   the  conscious  mind  in 
l»w.        relation  to  disease!     I  have  fully  pointed  this  out 
already.     The  conscious  mind  cannot  directly  cause 
(without  the  agency  of  the  unconscious  mind)  any 
SSStny    disease  whatever  save  malingering,  which,  after  all, 
is  not  a  true  disease ;  nor  can  it  cure ;  for  though  it  ap- 
pears able  to  do  so,  it  is  only  of  use  as  it  acts  indirectly 
through  the  unconscious  mind. 

Malingering  is  of  some  interest  in  this  light, 
as  I  believe  it  is  the  only  disease  (?)  in  which  the 
unconscious  mind  plays  no  part  whatever. 

The  main  agency,  then,  of  all  cures  is  the  force 
of  mind,  which  operates  always  naturally,  but  may 


THE  PEACTICAL  CONCLUSION  275 

also  be  made  to  act  artificially.    In  every  disease  its 
ordinary  action  by  the  vis  medicatrix  natura  is  at  once  Power  of 
evident,  whether  in  pouring  out  lymph  round  a  broken  Sd? 
bone,  in  sealing  up  an  abscess  with  an  impenetrable  catrix 
wall,   in  digging  out  new  vascular  channels  in  a 
diseased  limb,  in  extracting  gout  by  the  cells  of  the 
convoluted  kidney  tubes,  in  quickly  eliminating  C02 
by  rapid  expiration,  or  mucus  by  constant  coughing, 
in  forming  antitoxins,  or  marshalling  leucocytes,  or  in 
a  thousand  other  ways. 

But  besides   this  the  unconscious  mind  can  be  Special 
stimulated  to  special  work  where  needed,  and  par-  JS 
ticularly  in    those   diseases  of  functional  neuroses 
where  it  has  already  played  such  a  large  part  in 
aetiology. 

This  stimulation  must  as  a  rule  be  applied 
through  consciousness  indirectly,  but  can  also  be 
used  directly. 

The  former  action  is  illustrated  in  all  treatment  Methods  of 
that  appeals  to  the  patient's  reason— methods  that 
he  sees  and  feels,  that  he  knows  are  intended  to  cure 
him,  that  impress  him  with  their  power.  He  is  con- 
scious of  their  good  effects.  He  feels  better  for  their 
application,  though  all  the  time  he  is  wholly  uncon- 
scious that  they  have  benefited  him  through  the 
mind  and  not  through  the  body.  If  he  knew  this, 
in  many  cases  no  cure  would  result,  for  material 
remedies  are  in  favour  at  a  heavy  premium,  while 
mental  medicine  is  in  the  shade  at  a  large  dis- 
count. 

It  is  for  this  reason  that  most  successful  sugges- 
tions must  be  made  indirectly,  not  ostensibly  directed 
to  the  mind  at  all,  though  scientific  analysis  shows 


276  THE  FOBCE  OF  MIND 

that  it  is  solely  through  this  channel  that  they  are 
efficacious. 

Direct  But  the  unconscious  mind  can  also  be  reached 

byghy^^   therapeutically  directly,  without  any  conscious  process 
tism-          whatever  ;  and  this  in  two  ways. 

Hypnotism  is  one;  a  power  that  abolishes  con- 
sciousness and  addresses  suggestions  directly  to  the 
unconscious  mind,  which  is  in  this  condition  easily 
reached  and  powerfully  affected.  It  can  be  made  in 
the  hypnotic  state  to  act  directly  on  the  body,  and 
produce  gross  organic  changes  in  a  way  incredible  if 
not  established  by  innumerable  experiments. 
Dims*  But  apart  altogether  from  this  method,  which  I 

b^the*1011   m  n°  way  recommend  for  general  practice,  even  were 
wet3""1'8  a^  doctors  competent  to  use  it,  there  is  another  way 
of  directly  acting  on   the  unconscious  mind  of  the 
patient,  and  that  is  through  the  mental  personality  of 
the  physician. 

It  is  perhaps  best  that  the  patient  should  in  this 
case  be  only  conscious  of  the  good  results  rather  than 
of  their  cause ;  but  the  physician,  while  never  self- 
conscious,   should  certainly  know  all   that  can  be 
known  of  the  power  he  is  wielding  every  day,  in  being 
what  he  is,  and  looking  and  speaking  as  he  does. 
&™t*          Of  this  P°wer  ne  is  at  present  taught  nothing 
neutralise    scientifically;  what  little  he  suspects  he  arrives  at 
ihe  power.    mtuitivelV)  and  f eels  nftlf  aBhamed  of,  as  he  resolutely 
sets  his  face  towards  the  material  and  turns  his  back 
on  the  psychical. 

This,  however,  alters  nothing,  and  patients  are 
helped  or  hindered,  diseases  cured  or  aggravated, 
however  confirmed  an  agnostic  the  doctor  may  be  in 
the  psychic  therapy  he  unconsciously  uses. 


THE  PEACTICAL  CONCLUSION  277 

In  a  hardly  less  degree  is  psychic  training  essen- 
tial for  the  nerve  nurse. 

This  being  exists   only  at  present  in   the  early  NO  trained 
embryonic  stage,  save  as  an  entirely  chance  product. 
No  hospital  manufactures  her,  no  examination  or 
manuals  exist  for  her. 

For  the  surgical  nurse,  the  general  medical  nurse, 
and  even  the  mental  disease  nurse,  how  complete  are 
the  organisation  and  equipment !  She  is  taught  all 
that  she  needs  to  know,  and,  in  the  opinion  of  some 
competent  observers,  often  a  good  deal  that  she  need 
not  know.  It  is  only  in  the  domain  of  functional 
nerve  disease,  only  in  the  knowledge  of  the  force  of 
mind,  that  the  '  trained '  nurse  remains  untrained. 

She  takes  her  cue  unconsciously  from  the  physi-  Nnrw> 
cian's  attitude ;  and  so  long  as  he  greets  the  anxious  d°ooto?s 
nerve  sufferer  with  the  '  Oh  !  it's  nothing — nothing '  lead> 
(recalling  poor  old  Toole  in  the  '  House-boat '),  what 
can    the    nurse    do    but,    parrot-like,    re-echo    the 
cry? 

There  are  of  course  gifted  women  whose  uncon- 
gcious  mind,  or  as  we  say  'intuition,'  makes  them  able 
attendants  upon  nerve  cases ;  but  they  are  chance 
products,  and  owe  nothing  of  their  power  to  their 
training. 

Here,  then,  in  this  neglect  of  the  study  of  the 
force  of  mind  is  the  weak  spot  in  the  whole  system 
of  medicine ;  and  it  is  because  of  this  I  have  written, 
quoted,  repeated,  and  reiterated  all  that  I  have  re- 
garding the  '  mental  factor  in  medicine.'  I  will  very 
briefly  review  what  has  been  said. 

The  first  part  of  this  book  treats  of  '  the  action  ch»Pur  i, 
of  mind  in  causing  disease.'     Chapter  I.  commenced 


278  THE  FOECB  OF  MIND 

with  the  analysis  of  a  remarkable  letter  of  Sir  James 
Paget,  that  revealed  as  by  a  search-light  the  weakness 
of  the  medical  position  in  the  matter,  and  I  continued 
throughout  that  chapter  to  point  out  the  neglect  of 
mental  therapeutics  and  the  disastrous  results  of  this 
neglect. 

The  point  to  be  proved  in  Chapter  II.  was  that, 
'  as  the  action  of  the  mental  factor  in  disease  is  un- 
conscious, it  cannot  be  recognised  as  mental  by  those 
who  limit  mind  to  consciousness.  The  word  "  mind  " 
must  therefore  be  extended  to  include  all  psychic 
action.' 

This,  I  trust,  is  evident  to  all  who  have  followed 
the  line  of  argument.  The  mind  is  one  and  indivi- 
sible. Part  of  it  is  seen  by  the  mental  faculty  or  eye 
we  call  consciousness,  just  as  part  of  our  body  is  open 
to  our  gaze.  The  rest  is  no  less  mind  because 
beyond  the  range  of  vision,  any  more  than  those 
parts  of  the  body  are  not  corporeal  which  are  outside 
the  range  of  sight.  Their  existence  can  be  easily 
proved  by  other  faculties,  just  as  the  unconscious 
mind  can  be  proved  without  the  aid  of  consciousness. 
I  say  nothing  of  double  consciousness,  as  I  cannot 
here  speak  of  consciousness  as  being  any  other  than 
that  with  which  we  are  familiar  in  our  normal  state. 
There  may  be  other  consciousnesses  ;  for  our  purpose 
they  are  termed  « unconscious.' 

The  narrow  range  of  the  conscious  mind,  com- 
pared with  the  wide  field  of  the  unconscious,  has  been 
also  noted  here. 

chapter  In  Chapter  III.  the  thesis  to  be  proved  is  that 

1  the  double  action  of  the  mental  factor  on  the  body 
in  health  consists  generally  in  carrying  on  the  func- 


THE  PEACTICAL  CONCLUSION  279 

tions  of  life,  and  specially  in  physically  expressing 
mental  states.' 

Here  we  approach  the  three  neglected  branches  of 
medical  study — psycho-physiology,  or  the  action  of 
the  mind  on  the  body  in  health ;  psycho-pathology,  or 
its  action  in  causing  disease ;  and  psycho-therapy, 
or  its  power  in  curing  disease.  The  necessity  for  a 
governing  centre  to  maintain  the  harmonious  action 
of  the  various  systems,  and  intelligently  direct  them 
to  a  common  end,  is  insisted  on,  and  illustrations 
given  of  the  power  of  the  mind,  conscious  and  uncon- 
scious, over  the  various  systems  of  the  body. 

In  Chapter  IV.  I  have  sought  to  show  that '  the  Chapter 
mental  factor  is  present  in  all  diseases,'  both  func- 
tional and  organic.  No  doubt  in  most  it  plays  but  a 
small  part ;  what  I  contend  for  is  that  it  plays  some 
part.  This  is  not  perhaps  a  subject  capable  of  exact 
proof ;  but  from  the  instances  one  can  adduce  in  so 
many  different  classes  of  disease  it  is  made  exceed- 
ingly probable  that  when  increased  facilities  for  study 
are  afforded,  it  will  be  traced  in  all.  The  value  of 
the  face  in  diagnosis  is  pointed  out ;  though,  I  may 
add,  he  who  diagnoses  by  face  alone  is  guilty  of  grave 
neglect  of  duty  in  not  using  the  other  methods  of 
physical  examination  at  his  disposal. 

Chapter  V.  is  written  to  show  that  'we  have  Chapter v. 
examples  of  the  mind  as   a   causal  factor  in  most 
organic  diseases,'  and  numerous  examples  are  given 
to  prove  this,  together  with  many  also  of  functional 
disease,  and  some  when  death  is  caused. 

Chapter  VI.  is  devoted  to  the  symptoms  of  func-  chapter 
tional  nerve  disease,  and  especially  neurasthenia. 

The  opprobrium  attaching  to  the  word  '  hysteria* 


280  THE  FOECE  OF  MIND 

is  alluded  to,  and  the  fact  that  this  is  a  disease,  and 
differs  entirely  from  malingering,  which  is  not  one. 

Neurasthenia  is  another  distinct  functional  nerve 
disease,  differing  both  in  cause  and  symptoms  and 
also,  as  we  shall  see,  in  treatment. 

Chapter  In  Chapter  VII.,  where  I  deal  with  hysteria  more 

particularly,  I  try  to  show  that  '  the  chief  factor  in 
hysteria  is  the  unconscious  mind,'  because  on  this 
fact  really  depends  the  true  understanding  of  the 
disease.  Once  it  is  grasped,  there  is  no  longer  any 
need  for  the  constant  feeling  that  there  must  be 
some  amount  of  fraud  in  cases  of  neuromimesis,  which 
always  exists  as  long  as  the  simulation  is  believed  to 
be  conscious  and  voluntary. 

chapter  Having    established    the    basis   of    hysteria,  in 

Chapter  VIII.  I  give  details  of  its  phenomena,  and 
several  illustrative  cases  to  show  that '  the  phenomena 
of  hysteria  are  due  to  the  perverted  action  of  the 
unconscious  mind.' 

With  this  chapter  we  reach  the  end  of  the  first 
part  of  the  book,  treating  of  mind  as  a  cause  of 
disease,  and  turn  in  the  second  part  to  a  consideration 
of  the  force  of  mind  in  curing  disease,  or  to  psycho- 
therapy. 

Chapter  In  Chapter  IX.  the  subject  before  us  is  the  con- 

nection of  mental  therapeutics  with  every  form  of 
quackery,  and  I  show  that  'the  force  of  mind  in 
therapeutics  so  largely  ignored  by  the  profession  is 
generally  exploited  by  quacks  for  their  own  ends.' 

The  fact  is  that  psycho-therapy,  though  so  disliked 
by  the  profession,  is  the  very  bread  of  life  to  all 
quacks ;  and  I  pointed  out  the  evil  of  this  long  ago 
in  a  letter  to  '  The  Lancet,'  which  I  quote.  It  is  out- 


THE  PEACTICAL  CONCLUSION  281 

rageous  that  a  power  that  is  putting  tens  of  thousands 
of  pounds  every  year  into  unprofessional  pockets 
should  be  treated  by  medical  men  with  such  scant 
courtesy ;  not  only  to  their  own  injury,  as  shown  in 
that  remarkable  letter  of  Sir  J.  Paget  with  which 
this  book  opens,  but  also  to  the  injury  of  their 
patients. 

In  Chapter  X.  I  give  '  the  testimony  of  the  pro-  chapter  x. 
fession  to  the  presence  and  importance  of  the  vis 
medicatrix  natures,  and  the  power  of  mind  over 
disease,'  and  in  addition  I  furnish  many  instances 
that  show  how  much  is  owed  to  this  force  throughout 
life. 

Chapter  XI.  is  on  mental  therapeutics  generally  chapter 
and  faith  cures  specially,  and  shows  that  *  the  effec-  XL 
tive  agent  in  all  faith  cures  is  the  unconscious  mind.' 
In  this  chapter  I  have  tried  to  give  some  account  of 
Christian  Science,  as  well  as  of  some  of  the  wonders 
of  hypnotism. 

Chapter  XII.  is  written  to  show  that '  the  force  Chapter 
of  mind  is   a   therapeutic  agent  in  every  disease.'  xn< 
Just  as  in  Chapter  IV.  I  showed  that  the  mental 
factor  is  present  in  all  diseases  as  cause,  so  here  I 
try  to  show  the  same  with  regard  to  cure. 

In  Chapter  XIII.  we  come  to  the  cure  of  func-  chapter 
tional  nerve  diseases,  and  I  show  that  they  '  are  mostly 
cured  by  suggestions  presented  in  various  ways,'  so 
various,  indeed,  that  many  of  them  are  not  recognised 
by  the  patients  as  suggestions  at  all. 

Chapter  XIV.  shows  that  '  success  in  the  treat-  gap** 
ment  of  neurasthenia  depends  equally  on  psychical 
and  physical  details,'  and  in  it  I  give  a  good  many 
hints  upon  which  good  results  more  or  less  depend ; 


282  THE  FOECE  OF  MIND 

most  of  which  were  embodied  in  a  paper  I  read  before 
the  British  Medical  Association  at  Cheltenham  in 
1901. 

chapter  Chapter  XV.  proves  that  'in  hysteria  the  cure 

XVl  lies  in  restoring  the  healthy  action  of  the  unconscious 

mind,'  the  perverted  action  of  which  caused  the 
disease  in  the  first  place,  at  any  rate  where  neuro- 
mimesis  is  a  feature. 

And  now  that  I  have  written,  quoted,  and  reiterated 
and  summarised  all  this,  comes  the  final  question  : 

I8  there  a  Do  my  readers  agree  as  to  the  importance  of  my  sub- 
ject, as  to  the  general  neglect  with  which  it  is  treated, 
and  as  to  the  need  that  exists  for  making  its  study 
a  part  of  the  medical  curriculum  ?  If  so,  I  am 
rewarded  for  any  little  time  and  trouble  I  have  taken 
to  bring  this  subject  forward.  If  not,  it  simply  means 
working  on  till  I  do. 

Fight  for  And  in  this  I  have  the  encouragement  of  previous 
success.  Some  years  ago  I  determined  to  try  and 
get  personal  and  domestic  hygiene  and  the  common 
laws  of  health  everywhere  taught,  and  I  found  that 
to  do  this  they  must  first  become  subjects  of  ex- 
amination. By  memorials,  by  letters,  by  the  support 
of  the  National  Health  Society,  the  Sanitary  Insti- 
tute, and  other  bodies,  by  influential  private  help, 
not  the  least  of  which  was  that  afforded  by  Sir 
Henry  Acland,  '  Hygiene '  was  at  length  included 
as  a  subject  for  the  intermediate  examinations  of 
Oxford  and  Cambridge  for  the  first  time  in  the  history 
of  those  Universities.  I  never  expected  such  speedy 
success  then,  and  only  hope  that  I  may  be  equally 
fortunate  now ;  and  that  here  also  the  heads  of  the 
medical  profession  will  seriously  consider  the  advisa- 


THE  PEACTICAL  CONCLUSION  283 

bility  of  having  this  important  subject  scientifically 
and  systematically  taught. 

There  is  no  doubt  that,  once  the  matter  is  well  Abler 
ventilated,  other   and  abler  workers  will  enter  this  wm  follow, 
field,  and  carry  the  whole  subject  far  beyond  the 
point  1  have  been  able  to  reach. 


LIST  OF  SOME  WRITERS  AND  THEIR 
WORKS  HELPFUL  IN  STUDYING  THE 
MENTAL  FACTOR  IN  MEDICINE. 


Advancement  of  Learning.     SIR  FRANCIS  BACON. 
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Alterations  de  la  Personnalite.     BINET. 
Anatomy  of  Melancholy.    BURTON. 
Animal  Intelligence.     G.  KOMANES. 
Animal  Magnetism.    BINET. 
Asclepiad*    SIR  B.  W.  KICHARDSON. 
BACON,  SIR  FRANCIS.    Advancement  of  Learning. 
BAIN,  A.     The  Power  of  the  Mind  over  the  Body. 
BARRETT,  PROF.    Humanitarian,  1895. 
BASTIAN,  C.     The  Brain  as  an  Organ  of  Mind. 
BATEMAN,  DR.    Practical  Symptoms  of  Cutaneous  Disease*. 
Bee,  Life  of  the.     MAETERLINCK. 
BENNETT,  W.  H.    Lancet,  1899. 
BERNHEIM,  PROF.     Suggestions  in  Therapeutict. 
BERNHEIM,  PROF.    Brain,  Vol.  16. 
BINET.     Animal  Magnetism. 
BINET.    Alterations  de  la  Personnalite. 
BOWEN,  PROF.     Modern  Philosophy. 
BRAID.    Hypnotism. 
BRAID.    Power  of  Mind  over  Body. 
Brain,  Vols.  15,  16,  17, 19.     1900. 
Brain  as  an  Organ  of  Mind.    C.  BASTIAN. 
BRAMWELL,  DR.   MILNE.    Hypnotic  Appreciation  of  Time: 
Brain,  1900. 


286  THE  FOKCE  OF  MIND 

BREUBB,  PROF.  (Vienna).     Neuroglisches  Centralblatt. 

BRIQUET.     Twentieth  Century  Practice  of  Medicine. 

British  Medical  Journal,  1870,  1886,  1889,  1890,  1896,  1897. 

1898,  1901. 

BBODIB,  SIR  B.     Psychological  Enquiries. 
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BRUNTON,  SIR  T.  L.    Disorders  of  Assimilation. 
BURTON.    Anatomy  of  Melancholy. 
BURT,  DB.    Bradshaw  Lectures. 
BUZZARD,  DR.  T.     Quairi s  Dictionary  of  Medicine. 
BUZZARD,  DR.  T.    Simulation  of  Hysteria  by  Organic  Nerve 

Disease. 

BUZZARD,  DR.  T.    Diseases  of  the  Nervous  System. 
CALDBRWOOD,  PROF.     The  Eolations  of  Mind  and  Brain. 
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CARTER,  DR.    Pathology  and  Treatment  of  Hysteria. 
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CASSIODORUS.    'Ep.'Lib.  I. 
CELSUS.    Lib.  III. 

CHARRIN,  DR.  A.    Les  Defentet  NatureUes  de  FOrganitme. 
Chiniquy,  Life  of  Father. 

CHURCH,  SIR  W.  S.    British  Medical  Journal,  1901. 
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CLARK,  SIR  A.    Lancet,  1855. 
CLIFFORD  ALLBUTT,  DR.    System  of  Medicine. 
CLOUSTON,  DR.    British  Medical  Journal,  1896,  1870. 
Curative  and  Health  Maxims.    DR.  W.  W.  HALL. 
Das  Leben  der  Seele.    PROF.  LAZARUS. 

Defenses  (Les)  Naturelles  de  VOrganisme.     DR.  A.  CHARRIN. 
Diseases  of  the  Nervous  System.    SIR  S.  WILKS. 
Discourses.    SIB  B.  W.  BICHARDSON. 
Diseases  of  the  Nervous  System.    DR.  T.  BUZZARD. 
Diseases  of  Women.    DB.  HERMAN. 
Dictionary  of  Psychological  Medicine.    DR.  H.  TUKH. 
Disorders  of  Assimilation.    SIR  T.  L.  BRUNTON. 
Dublin  Quarterly  Journal,  Vol.  44. 
DUNN,  E.    Psychological  Physiology. 
EDDY,  MRS.  M.  B.    Science  and  Health. 
EIOHHOBST,  PBOF.    Practice  of  Medicine,  1901. 


WEITEKS  AND  WORKS  ON  THE  SUBJECT  287 

ELAM,  C.     Psychological  Problems. 

ENGILMAN,  PROF.    Pfluger,  Archiv  fur  Physiologic. 

Faith  Cures.    GLIDDON. 

Faith-Healing,  On.     DR.  A.  T.  SCHOFIELD. 

Fat  and  Blood.    DR.  S.  W.  MITCHELL. 

First  Principles  of  Psychology.    HERBERT  SPENCER. 

FLETCHER,  DR.  E.     Sketches  from  the  Case-book. 

FLEURY,  DR.  DE.     Medicine  and  Mind. 

FORBES,  SIR  JOHN.     Nature  and  Art  in  Disease. 

FORD,  PROF.  A.     American  Journal  of  Psychology. 

FOSTER,  SIR  M.    Physiology. 

FREUD,  DR.     Studies  in  Hysteria. 

Functional  Nerve  Disease.    DR.  G.  H.  JONES. 

GAIRDNER,  SIR  W.     The  Physician  a  Naturalist. 

GAIRDNER,  SIR  W.    Medical  Education. 

GIBERT.     Medical  Journal  of  France,  1893. 

GIBSON,  DR.     Text-booTt  of  Medicine. 

GLEN,  J.     Mind  and  Body. 

GLIDDON.    Faith  Cures. 

GOODHART,  DR.     Lancet,  1889. 

GRANVILLE,  DR.  M.    Lancet,  1879. 

GRIESINGER,  DR.    Mental  Diseases. 

HALL,  DR.  W.  W.     Curative  and  Health  Maxinu. 

HART,  ERNEST.    Hypnotism. 

HARTMANN,  ED.  VON.    Philosophy  of  the  Unconscious. 

HEAD,  DR.    Brain,  Vol.  16. 

HERMAN,  G.     Diseases  of  Women. 

HODGSON,  SHADWORTH  H.    Proceedings  Aristotelian  Society, 

HOLLAND,  SIR  H.     Medical  Notes  and  Reflections. 

HOLLAND,  SIR  H.    Mental  Physiology. 

HOLMES,  O.  W.     Medical  Essays. 

How  the  Body  affects  the  Mind.     H.  SIMPSON. 

HUDSON,  T.  S.     The  Law  of  Psychic  Phenomena. 

Humanitarian,  1895. 

HUXLEY,  T.    Lay  Sermons. 

Hypnotic  Appreciation  of  Time.    DR.  M.  BRAMWBLL. 

Hypnotism.    BRAID. 

Hypnotism.    E.  HART. 

HYSLOP,  DB.    British  Medical  Journal,  1899. 

Influence  of  the  Mind  on  the  Body.    DR.  H.  TUKB. 


288  THE  FOECE  OP  MIND 

JAMES,  W.    Physiology. 

JAMBS,  W.    Principles  of  Physiology. 

JONES,  DB.  0.  H.    Functional  Nerve  Disease 

Kingsley,  Charles,  Life  of. 

KCHNB,  Louis.    New  Science  of  Healing. 

LADD,  G.  T.    Physiological  Psychology. 

LADD,  G.  T.     The  Philosophy  of  Mind. 

Lancet,  1855,  1873,  1879,  1880,  1883,  1885,  1888,  1889,  1892 

1894,  1897,  1899. 

LANE,  DB.  ABBUTHNOT.    British  Medical  Journal,  1896. 
Law  of  Psychic  Phenomena.    T.  J.  HUDSON. 
LAYCOCK,  DB.  T.     The  Mind  and  Brain. 
LAYCOCK,  DB.  T.    Reflex  Cerebration. 
LAYCOCK,  DB.  T.    Nervous  Diseases  of  Women. 
Lay  Sermons.    T.  HUXLEY. 
LAZABUS,  PBOF.    Das  Leben  der  Seele. 
Lectures  by  SIB  G.  PAGET. 
LEWES,  G.  H.    Problems  of  Life  and  Mind. 
LEWES,  G.  H.    Physiology  of  Common  Life. 
Life  of  Sir  J.  Paget.     PAGET. 
Life  of  Charles  Kingsley. 
Life  of  Father  Chiniquy. 
MAETEBLINCK.     The  Life  of  the  Bee. 
MARSH,  SIB  H.     Dublin  Quarterly  Review,  Vol.  44. 
Materia  Medica  and  Therapeutics.    DB.  PEBBIBA. 
MAUDSLEY,  DB.  H.    Mind  and  Body. 
MAUDSLBY,  DB.  H.     The  Physiology  of  Mind. 
MAYO,  DB.  T.  J.     On  Therapeutic  Forces. 
Medical  Education.    SIB  W.  GAIBDNBB. 
Medical  Essays.     0.  W.  HOLMES. 
Medical  Essays.    DB.  J.  H.  SEALY. 
Medical  Inquiries.    DB.  B.  RUSH. 
Medical  Notes  and  Reflections.     SIB  H.  HOLLAND. 
Medical  Pathology.     DB.  H.  G.  SUTTON. 
Medical  Times,  1872. 
Medicine  and  Mind.    DB.  DE  FLEUBY. 
Mental  Diseases.    DB.  GRIESINGBB. 
Mental  Physiology.    DB.  CABPENTEB. 
Mental  Physiology.     SIB  H.  HOLLAND. 
MKBCIEB,  DB.  C.    Nervous  System  and  the  Mind. 


WRITERS  AND  WORKS  ON  THE  SUBJECT    289 

Mind,  Vol.  6. 

Mind  and  Body.     DB.  H.  MAUDSLBI. 

Mind  and  Body.    J.  GLEN. 

Mind  and  Brain.    DB.  T.  LAYCOCK. 

Mind  in  Relation  to  Brain.     DB.  NOBLB. 

MITCHELL,  DB.  S.  WEIB.    Fat  and  Blood, 

MITCHELL,  DB.  S.  WEIB.     The  Physician. 

MITCHELL,  DB.    S.    WBIB.    Journal   of  American   Medical 

Association. 

Modern  Philosophy.    BOWEN. 

MOORE,  DB.  G.     Use  of  the  Body  in  Relation  to  the  Mind. 
MOORE,  DB.  G.     The  Power  of  the  Soul. 
MOBBISON,  DR.  A.     Practitioner,  1892. 
Nature  and  Art  in  Disease.     SIB  J.  FOBBBS. 
NEALB,  DB.    British  Medical  Journal,  1896. 
Nervous  Diseases  of  Women.    DB.  T.  LAYCOCK. 
Nervous  System  and  the  Mind.     DB.  C.  MEBCiEBi 
New  Science  of  Healing.     Louis  KTJHNB. 
NOBLE,  D.     Mind  in  Relation  to  Brain. 
NOTHNAGEL,  DB.     Studies  in  Therapeutics. 
On  the  Use  of  the  Will  for  Health.    SIB  J.  PAGB* 
OBMEBOD,  DB.    Allbutt's  System  of  MedicvM. 
Our  Temperaments.     S.  STEWABT. 
OWEN,  DB.    Lancet,  1892. 
PAGET.    Life  of  Sir  James  Paget. 
PAGET,  SIB  GEORGE.    Lectures. 

PAGET,  SIB  JAMES.     On  the  Use  of  the  Witt  for  Health. 
PAGET,  SIR  JAMES.    Studies  of  Old  Cases. 
Pathology  and  Treatment  of  Hysteria.    DB,  B.  CABTBB. 
PEBEIBA,  DB.     Materia  Medica  and  Therapeutics. 
PETBEN,  KABL.     Deutsche  Zeitschrift  fur  NervenheiUcu*d«, 

Bd.  xvii. 

Philosophy  of  Mental  Healing.    DB.  WHIPPLE. 
Philosophy  of  Mind.    PBOF.  G.  T.  LADD. 
Philosophy  of  the  Unconscious.     ED.  VON  HABTMANH. 
Physician  a  Naturalist.    SIR  W.  GAIBDNHB, 
Physician,  The.    DB.  S.  W.  MITCHELL. 
Physiology.    W.  JAMES. 
Physiology.    SIB  M.  FOSTEB. 
Physiology  of  Common  Life.    G.  H.  LEWES. 

of 


290  THE  FOECE  OF  MIND 

Physiology  of  Mind.    DR.  H.  MAUDSLBY. 

Physiological  Psychology.    G.  T.  LADD. 

Physiological  Psychology.    DR.  WUNDT. 

PLATO.    Republic. 

PLAYFAIR,  DR.    British  Medical  Journal,  1888. 

Power  of  the  Mind  over  the  Body.    A.  BAIN. 

Power  of  the  Mind  over  the  Body.    BEARD. 

Power  of  the  Soul.    DR.  G.  MOORB. 

Practical  Symptoms  of  Cutaneous  Diseases.    DE.  BATEMA>, 

Practitioner,  Vol.  34,  1892. 

PRINCE,  DR.  MORTON.    Journal  of  Nervous  Diseases,  Bost»  a, 

1891. 

Principles  of  Psychology.     W.  JAMES. 
Problems  of  Life  and  Mind.     G.  H.  LEWBS. 
Proceedings  of  Aristotelian  Society. 
Proverbs  of  King  Solomon. 
Psychological  Enquiries.     SIR  B.  BRODH. 
Psychological  Essays.     T.  WHITTAKEB. 
Psychological  Physiology.     R.  DUNN. 
Psychological  Problems.    C.  EI.AM. 
Quain's  Dictionary  of  Medicine. 
Reflex  Cerebration.    DR.  T.  LAYCOCK. 
Relations  of  the  Mind  and  Brain.     PROF.  CALDERWOOD. 
BBNNIE,  DR.  G.  E.    British  Medical  Journal,  1901. 
Republic,  The.    PLATO. 
RICHARDSON,  SIR  B.  W.    Discourses. 
RICHARDSON,  SIR  B.  W.     The  Study  of  Diseato. 
RICHARDSON,  SIR  B.  W.     The  Asclepiad. 
ROBERTSON,  DR.  Lancet,  1894. 
ROMANES,  G.    Animal  Intelligence. 
RUSH,  DR.  B.    Medical  Inquiries. 
SANSOM,  DR.     Twentieth  Century  Practice  of  Medicine 
SCHOFIELD,  DR.  A.  T.     The  Unconscious  Mvnd. 
SCHOFIELD,  DR.  A.  T.     The  Springs  of  Character, 
SCHOFIELD,  DR.  A.  T.    Lancet,  1894. 
SCHOFIELD,  DR.  A.  T.     On  Faith-Healing. 
Science  and  Health.    MRS.  M.  B.  EDDY. 
SEALY,  DR.  J.  H.    Medical  Essays. 
SEMON,  SIR  F.    British  Medical  Journal,  1901. 
SHARPS,  DR.  GORDON.    Lancet,  1894. 


WRITERS  AND  WORKS  ON  THE  SUBJECT    291 

SHOEMAKER,  DR.     Therapeutics. 

SIMPSON,  H.     How  the  Body  affects  the  Mind. 

Simulation  of  Hysteria.    DR.  T.  BUZZARD. 

Sketches  from  the  Case-book.    DR.  E.  FLETCHER. 

SMITH,  DR.  PYE.    British  Medical  Journal,  1897. 

SNOW,  DR.    Lancet,  1880. 

SOLOMON,  KINO.    Proverbs  of. 

SPENCER,  HERBERT.    First  Principles  of  Psychology. 

Springs  of  Character.    DR.  A.  T.  SCHOFIELD. 

STEWART,  S.     Our  Temperaments. 

Studies  of  Old  Cases.     SIR  JAMES  PAQBT. 

Studies  in  Therapeutics.     NOTHNAGBL. 

Studies  in  Hysteria.    DR.  BREUER. 

Studies  in  Hysteria.    DR.  FREUD. 

Study  of  Disease.    SIR  B.  W.  RICHARDSON. 

Sub-conscious  Self.    DR.  WALDSTEIN. 

Suggestion  in  Therapeutics.     PROF.  BERNHBDC. 

BUTTON,  DR.  H.  G.    Medical  Pathology. 

System  of  Medicine.    DR.  C.  ALLBUTT. 

Text-book  of  Medicine.     DR.  GIBSON. 

Therapeutic  Forces,  On.    DR.  T.  J.  MAYO. 

TJierapeutics.     DR.  SHOEMAKER. 

TREVES,  SIR  F.    British  Medical  Journal,  1898. 

TUKE,  DR.  H.    Dictionary  of  Psychological  Medicine. 

TUKE,  DR.  H.     The  Influence  of  tlie  Mind  on  the  Body. 

Twentieth  Century  Practice  of  Medicine.    VAN  NOORDEN. 

Unconscious  Mind.     DR.  A.  T.  SCHOFIELD. 

Use  of  the  Body  in  Relation  to  the  Mind.    DR.  G.  MOORB. 

Use  of  tJie  Witt  for  Health.     SIR  J.  PAOET. 

VAN  NOORDEN.     Twentieth  Century  Practice  of  Medicine. 

WALDSTEIN,  DR.     The  Sub-conscious  Self. 

WHIPPLE,  DR.     Philosophy  of  Mental  Healing. 

WHITE,  DR.  T.    Mind,  Vol.  6. 

WHITTAKBR,  T.     Psychological  Essays. 

WILKINSON,  DR.    Lancet,  1897. 

WILKS,  SIR  S.     Diseases  of  the  Nervous  System. 

WILKS,  SIR  S.     British  Medical  Journal,  1870. 

WUNDT,  DB.    Physiological  Psychology. 


INDEX  OF  SUBJECTS 


U.M.  =  unconscious  mind 
V.M.N.  =  tns  medicatrix  natures 


ABDOMINAL  hysterical  tumours,  137 
Accident— exciting  cause  in  hys- 
teria, 136 

Acland,  Sir  Henry,  letter  to,  2 
Action  of  body  on  mind,  76 
Action  of  conscious  mind  is  small, 

39 
Action  of  mind  in  causing  disease, 

1-144;  in  curing  disease,   147- 

283 

Action  of  U.M.  is  great,  39 
Address,  the  inaugural,  190 

altruistic  note  in,  190 
Advance  in  current  thought,  10 ; 

in    medicine  one-sided,  9  ;   real 

and  great,  10 
^Etiology     of     functional     nerve 

disease,  98-111 

of  hysteria,  112,  253 
After  cure  in  nerve  disease,  251 
Agnostic  attitude  of  doctors,  154, 

162 

Aim  of  all  evolution — the  cortex,  72 
Alienist,  priest,  philosopher,  20 
Allbutt,  Dr.  C.,  on  nervous  system, 

106 

on  neurasthenics,  104,  106 
All-round  doctor, 
Alteratives  break  habits,  222 
Amazing  picture,  an,  3 
Amblyopia,  hysterical,  138 
America  and  neurasthenics,  104 
Anaemia,  mental  origin,  83 
Anaesthesia  and  hysteria,  185 
hysterical,  128 


Anasarca,  mental  origin,  88 

Ancients  and  U.M.,  87 

Answer  to  'Brit.  Med.  Jour.,'  book 

written  as,  vii 
Antiquity  of  mental  therapeutics, 

181 

Aphasia,  hysterical,  138 
Aphonia,  hysterical,  258 
Arcellffl,  action  of,  27 
Aristotelian  consciousness,  85 
Aristotle  on  mind,  37 
Art  of  healing  depends  on,  172 
Artists  and  U.M.,  60 
Assertion,  force  of,  4 
Assets  of  a  physician,  23 
Atheroma,  mental  origin,  88 
Australian  ants,  29 
Automata,  conscious,  34 

BACON,  Sir  F.,  on  mind  and  body,  70 
Bad  suggestions  must  be  removed, 

229 

Bain  on  value  of  cortex,  50 
Balancing  and  vertigo,  59 
Barrett,  Prof.,  on  stigmata,  62 

on  unconscious    impressions, 

117 ;  on  U.M.,  61 
Barristers  and  dyspepsia,  84 
Bastian,  Dr.  0.,  on  psychology,  38 

on  U.M.,  40 
Beard,  Dr.,  on  mental  therapeutic!, 

185 
on  symptoms  of  neurasthenia, 

109 
Bed  rest  in  neurasthenia,  247 


294 


THE  FORCE  OF  MIND 


Bigi,  Dr.,  on  gastric  ulcer,  139 
Bell  and  hall-door,  119, 132 
Bennet,  Prof.,  and  D.M.,  63 
Bernheim,  Prof.,  on  hysteria,  126 

on  hysterical  retention,  139 
Bias  in  book  explained,  viii 
Biener,  Prof.,  on  secondary  con- 
sciousness, 125 

Binet,  Dr.,  on  faith-healing,  198 
Biography  of  Sir  James  Paget,  1 
Blood-vessels  and  U.M.,  65 
Blushing,  56 

Body    and    mind    connected    in 
melancholy,  9 

a  unity,  33 

controlled  by  cortex,  49 

governing  centre  of,  49 

intelligence  in,  174 

not  a  syndicate,  38 

on  mind,  action  of,  76 

organs  and  the  Bible,  49 

mental  states,  49 

organ  of  mind,  48 

safety-valve  in,  176 

spirit,  soul,  20 
Boers  in  Africa,  6 
Bold  quack,  power  of,  4 
Book,  bias  in,  explained,  viii 

is  answer  to  '  Brit.  Med.  Jour.' 
vii 

innumerable  quotations  in,  ix 

omission  in,  ix 

reason  for  writing  it,  272 

summary  of,  277-282 

why  chosen,  44 

Books,  none  on  therapeutics,  181 
Bowen,  Professor,  on  mental  fac- 
tor, 192 

Brain  seat  of  all  sensations,  118 
Bramwell,  Dr.,  on  hypnotism,  206 
Breuer  and  Freud,  Drs.,on  hysteria, 

134 

Briquet  on  hysteria,  126 
British  Army  hi  Africa,  6 
British   Medical  Association  and 

psychology,  8 

'  British  Medical  Journal '  on  men- 
tal therapeutics,  163 ;  on  mind 
influence,  11 
Brodie,  Sir  B.,  on  mental  factor,  18 


Browne,  Sir  J.  C.,  on  mental  factor, 
17,18 

on  success,  21 

Bruce,  Dr.  M.,  on  V.M.N.,  172,  176 
Brunton,  SirLauder,  on  V.M.N.,  179 
Burton  on  faith-healing,  197 
Bury,     Dr.,    on    functional    and 

organic  diseases,  130 
Buzzard,  Dr.,  on  hysteria,  126 
on  hysterical  symptoms,  255 
on  hysterical  paraplegia,  268 

CALCULUS  and  mind,  88 

Calderwood,    Dr.,    on    mind    and 
body,  19 

Cancer  and  the  mind,  88 
Dr.  Murchison  on,  88 ;  Dr.  Snow 
on,  88 ;  Sir  George  Paget  on,  88 

Carpenter,  Dr.,  on  mental  thera- 
peutics, 201 

Carter,    Dr.   A.     H.,     on    mental 
factor,  19 

on  V.M.N.  170 

Carter,  Dr.  B.  B.,  on  mental  thera- 
peutics, 183 

Cassiodorus  on  physician's  person- 
ality, 192 

Castration,  Dr.  Clouston  on,  yl 

Cathell,    Dr.,    on    mental    thera- 
peutics, 184 

Cause  of  functional  nerve  disease, 
98-111 

Causes  of  neurasthenia,  106-108 
of  vitality  of  quackery,  151 

Celsus  on  physician's  personality, 
193 

Chaos  in  psychology,  33, 34 

Chapters,  review  of,  277-282 

Charm  cures,  161 

Charrin,  Dr.,  on  V.M.N.,  177 

Cheerful  countenance,  value  of,  194 

Chiniquy,  Pastor,  cured  by  saint,  218 

Choice,  evidence  of,  in  Arcellffl,  28 

Cholera  and  the  mind,  89;    Dr. 
Stokes  on,  89 

Christian  Science,  157 
work  of  cure  by,  202 
and  the  senses,  70 
what  it  is,  203 

Church,  Sir  W.  S.,  on  V.M.N.,  176 


INDEX  OP  SUBJECTS 


295 


Cinderella  of  medical  sciences,  228 
Circulation  and  U.M.,  54 
always  changing,  54 
Clark,   Sir  A.,  on  mental  thera- 
peutics, 182 
Classic  frog,  the,  26 
Classification  of  disease,  224 
Clergy  care  for  entire  man,  21 
Clifford  on  conscious  automata,  34 
Clock  in  constipation,  217 
in  labour,  216 
in  the  nursery,  217 
therapeutic  power  of,  216 
Clouston,  Dr.,  on  castration,  91 
on  hysteria,  99 
on  influenza,  90 
on  mental  disease,  84 
on  mental  therapeutics,  151, 

184,  199 
on  mind  and  body,   19;    in 

disease,  72  ;  cures,  165 
on  nervous  diathesis,  102 
on  sound  cortex,  96 
on  types  of  nerve  disease,  103 
on  value  of  cortex,  50 
Combining   unity   and   superficial 

diversity,  25 

Common-sense  talk,  value  of,  266 
Conclusion,  the  practical,  270-283 
Conflict  over  mind,  43 
Conscience,  seat  of,  46 
Conscious  and  unconscious  vibra- 
tions, 117 
automata,  34 
control,  86 

effort  not  neuromimesis,  113 
ends  and  unconscious  begins, 

53 

mimicry  is  fraud,  114 
mind  cannot  cause  disease,  274 
and  hypnotism,  205 
as  the  spectrum,  45 
has  little  power,  274 
power  over  heart,  61 

indigestion, 52 
kidneys,  52 
lungs,  52 
nervous    sys- 
tem, 53 
•mall  action  of,  39 


Consciousness,  no  mind  outside  of 
81 

mind  synonymous  with,  35 
Conscious   psychologist,  dilemma 
of  the,  32 

realm,  51 

Constipation,  clock  in,  217 
Consultant,  the  ideal,  21 
Controlling  unity  in  the  body,  32 
Co-operation  of  doctor  and  nurse, 

241 
Cortex  aim  of  all  evolution,  72 

and  disease,  72 

and  mind,  73 

and  drug  action,  152 

body  controlled  by,  50 

Dr.  Clouston  on  value  of,  50 

of  value,  50 

Curative  agent  in  Christian  Science, 
204 ;  U.M.,  162 

mental  qualities,  209 

power  of  mind,  illustrations  of 
211 

qualities,  Sir  J.  Forbes  on,  209 
Cures  and  the  public,  150 

at  spas,  161 

by  charms,  161 

by  dogmatism,  154 

by  fright,  220 

by  idols,  161 

by  relics,  161 

of  headaches,  215 

of  hysterical  tumours,  257 

orthodox,  162 

versus  diagnosis,  4 


DALE,  Dr.,  on  hysterical  hydropho- 
bia,  139  ;    paralysis,  267  ;    on 
mental  therapeutics,   184  ;    on 
nervous  dyspepsia,  221 
Dead  material  vitalised,  19 
Death  and  hysteria,  140 
caused  by  doctor,  96 
from  mental  causes,  95;  Dr. 
Tuke  on,  95 ;  Dr.  Walsh  on, 
95 

Defeat  and  victory,  89 
Definition  of  hypochondria,  105 
of  mind,  Prof.  James,  26 


THE  FOECE  OF  MIND 


De  Fleury  on  hysteria,  136 

on  mental  therapeutics,  187 

on  mind  and  body,  21 

on  nerve  doctors,  231 

on  slothful  neuropaths,  106 
Dependence    of    mind    on    body, 

156 

Descartes  on  mind,  37 
Description  of  nervous  diathesis, 

103 

Details,  value  of,  238 
Diabetes  of  mental  origin,  87 

Sir  B.  W.  Richardson  on,  87 

Van  Noorden  on,  87 
Diagnosis  by  observation,  77 

from  face,  77 

versus  cure,  4 
Diagnostic  symptoms  in  hysteria, 

130 

Diaz,  Dr.,  on  hysteria,  136 
Difference  often  fictitious,  68 
Difficult  suggestions  useless,  230 
Difficulty  of  mental  therapeutics, 
'  British  Medical  Journal  '   on, 
11,70 
Digestion  and  mind,  85 

and  U.M.,  56 

power  of  C.M.  over,  52 

Y.M.N.  in,  179 
Digestive  diseases,  mental  origin 

of,  84 
Dilemma  of  conscious  psychology, 

Direct  suggestion  by   hypnotism, 

276 ;  by  the  doctor,  276 
Discontinuance  of  nervous  system, 

43 

Disease  and  cortex,  72 
and  temperament,  75 
caused  by  manner,  270 
cured  by  manner,  271 
Disease,  Dr.  Laycock  on  physio- 
gnomy of,  36 
mental  factor  in,  80-97 
of  the  imagination  and  imagi- 
nary disease,  99,  100 
produced  by  intellect,  81 
resisted  by  V.M.N.,  175 
value  of  face  in,  76 
Diseased  mind,  psychology  of,  8 


Diseases,  list  of,  cured  by  faith,  160 

of    circulation    produced    by 
mind,  82 

of  heart  produced  by  mind,  82 

produced  by  emotion,  81 

sympathetic  origin,  82 

worse  at  night,  74: 
Disgust  at  irregular  tactics,  6 
Dislike  of  mental  therapeutics,  148 
Dislocated  hip  and  hysteria,  267 
Disseminated  sclerosis  and    hys- 
teria, 128 

Diversity  in  unity,  12,  32 
Drug  action  and  cortex,  152 
Drugs  altered  by  mind,  211 

empirical  use  of,  213 

inert,  213 

physical  and  psychic  action, 
211 

Unzer  on  psychic  action  of ,  2 12 

value  of,  164 

Doctor  and  nurse,  co-operation  of, 
241 

and  nursing  home,  245 

causes  death,  96 

cures  as  well  as  in  dicine,  153 

must  be  dogmatic,  243 

personal  value  of,  22 
Doctor's  face,  power  of,  193,  210 

interests,  190 

mind,  effect  of,  186 
Doctors,  agnostic  attitude  of,  154, 

162 

Dogmatism  cures,  154,  204 
Double  consciousness,  question  of, 
38 

ego,  the,  38 
Dualists  or  monists,  16 
Dyspepsia,  84 

hysterical,  Dr.  Ormerod  on, 
139 

EBBINGHAUS  on  mind,  31 
Eddy,  '  Eev."  Mary  Baker,  157 
Education  and  neurasthenia,  186 
Effects  of  doctor's  mind,  186 

on    cornea,   Prof.  Laycock 

on,  174 ;  on  pairing,  92 
on  mind  of  day  and  night,  74 
Ego,  the  double,  38 


INDEX  OF  SUBJECTS 


297 


Eichhorst  on  hysteria,  126 
Emotion,  diseases  produced  by,  81 

local  expressions  of,  53 

on  will,  53 

Empirical  use  of  drugs,  213 
Equilibration,  H.  Spencer  on  law 

of,  170 

Essential  unity  of  mind,  26 
Every-day  effects  of  mind  on  body, 

Evidence  of  choice  in  ArcellsB,  28 
Evil  of  false  religion,  260 
of  fixed  methods,  268 
Exaggeration  no  proof  of  fraud,  255 
Examples  of  U.M.  in  actions,  56 
4  Exciting '  cause  of  book,  vii 
Existence  and  life,  51 
Expectation,  terms  of,  101 


FACE  and  U.M.,  59 

diagnosis  from,  78 

in  disease,  value  of,  76 

mind  muscles  of,  76 
Faecal  vomiting,  mind  and,  86 
Faith  cures,  varieties  of,  202 

healing  at  home,  160;  Binet 
on,  198;  Burton  on,  197; 
1  Lancet '  on,  198 ;  no  miracle, 
198;  Paracelsus  on,  197; 
review  of,  196 

itself  does  not  cure,  198 

heals  subjectively,  197 
False  religion,  evil  of,  260 
Family  physician,  value  of,  195 
Fear  of  the  therapeutic  agent,  210 
Feeling  and  thinking,  120 
Feelings  and  ideal  centres,  121 
Female  deities  in  medicine,  38 
Few  reasoners,  many  observers,  16 
Fiction  in  maps,  68 
Fight  for  Hygiene,  282 
Finger,  pain  in  the  little,  119 
Firmness  in  treatment,  236 
Fixed  methods  bad,  268 
Flourens'  hens  and  Voit's  pigeons, 
27 

on  psychic  acts,  27 
Forbes,  Sir  John,  on  mental  thera- 
peutics, 185 


Force  o    assertion,  4 

of  mind,  no  lectures  on,  13; 
the,   1-24;   very   small  in 
many  diseases,  vili 
Foster,  Sir  M.,  on  the  frog,  26 
Four  reasons  for  dislike  of  mental 

therapeutics,  12 
types  of  nerve  disease,  103 
Fright,  cures  by,  220 
Frog,  the  classic,  25 

Sir  M.  Foster  on,  26 
Function  and  organic  disease,  Dr. 
Bury  on,   130;   symptoms,  Dr. 
Kennie  on,  129 

Functional  disease,  mental  thera- 
peutics in,  225-232 
nerve  disease,  causes  of,  98 ; 
ignorance  about,  99;    and 
malingering,  226 ;  maltreat- 
ment of,  225 ;  recently  re- 
cognised, 98 ;  symptoms  of, 
98 ;  treatment  of,  232-252 
and  organic,  68-70 
diseases  have  organic  basis, 

101 

what  is  it  ?  159 
neurasthenia,    symptoms    of, 
98-111 


GALEN  and  mind,  37 
Ganglionic  centres,  psychism  in,  29 
Gastric  ulcer,  Dr.  Bigi  on,  139 
General  view  of  psycho-pathology, 

67 

Genuine  cure  by  quacks,  154 
German  band  and  U.M.,  57 
Germany,  prayer-healing  in,  201 
Gibert,  Dr.,  on  mental  therapeu- 
tics, 221 

Gibson,  Dr.,  on  treatment  of  hys- 
teria, 261 

Gift  of  healing,  189 
Gliddon,  Dr.,  on  mental  therapeu- 
tics, 181 

Gout  and  mind,  Sydenham  on,  221 
Governing  centre  is  mental,  49  ;  of 

body,  49 

Granville,  Dr.,  on  mental   thera- 
peutics, 183 


298 


THE  FORCE  OF  MIND 


Graves'  disease,  Dr.  Lys  on,  90 
Gravitation,  law  of,  25 
Great  men  and  neuropaths,  101 
Growth  and  the  V.M.N.,  173 


HEMOPTYSIS,  Dr.  Sweetzer  on,  84 

Hair  and  U.M.,  61 

Hall-door  and  bell,  119-132 

Hand-made  cures  versus  machine- 
made,  242 

Hands,  sensation  in,  116 

Harness's  belts,  223 

Hartmann  on  U.M.,  43 

Hay  fever  and  U.M.,  58 

Headache,  cure  of,  215 

Healing,  gift  of,  189 

Health,  science  and,  157 

Hearing  and  U.M.,  64 

Heart  and  mind,  Huchard  on,  82 

and  U.M.,  54 
disease  cured  by  loss  of  reason, 

214 

power  of  conscious  mind  over, 
51 

Hens  and  pigeons,  27 

Herbert  Spencer  on  law  of  equi- 
libration, 170 ;  on  mind  and 
matter,  17 

Hereditary  nerves,  102 

Herman,  Dr.,  on  hysteria,  113,  124 
on  nerves  and  mind,  82 

Hippocrates  on  V.M.N.,  176 

Hodgson,  Prof.,  on  consciousness 
and  mind,  35 

Hoffding,  Prof.,  on  U.M.,  36 

Holmes,   Dr.,    effect   of  U.M.   on 

Holmes,  Prof.  0.  W.,  on  V.M.N.,  175 
Homes,  faith-healing,  160 

nursing,  245 
Homoeopathy,  159 
Honesty  hi  treatment,  238 
Hospitals  ignore  mental  therapeu- 
tics, 13 

Huchard,  Dr.,  on  mind  and  heart,  82 
Hughes,  Prof.,  on  conscious  auto- 
mata, 34 

Hunter's  (Dr.  J.)  stratagem,  229 
Hydropathy,  159 


Hygiene,  fight  for,  282 
Hypnotism  and  conscious  mind, 
205 

and  memory,  206 
Dr.  Bramwell  on,  206 
faith  cures  better  than,  205 
not  successful  in  cure,  265 
physical  phenomena  in,  208 
sense  of  time,  207 
Hypochondria,  definition  of,  105 

not  neurasthenia,  105 
Hysteria,  accident  an  exciting  cause 

in,  136 

a  disease  of  the  U.M.,  113 
aetiology  of,  112 
and  anaesthesia,  135 
and  Babinski's  phenomenon, 

131 

and  death,  140 
and  diagnostic  signs  hi,  130 
and  digestion,  139 
and  dislocated  hip,  267 
and    disseminated    sclerosis, 

128 

and  inhibition,  127 
and  insanity,  98 
and  malingering,  114 
and  necrosis,  140 
and  organic  disease,  127 
and  paralysis  agitans,  141 
and  sensation,  141 
and  special  senses,  138 
and  structural  change,  130 
and  urinary  system,  139 
Dr.  Bernheim  on,  126 
Drs.  Breuer  and  Freud  on, 

134 

Dr.  Briquet  on,  126 
Dr.  Buzzard  on,  126 
Dr.  Clouston  on,  99 
Dr.  de  Fleury  on,  136 
Dr.  Diaz  on,  136 
Dr.  Rennie  on,  118 
Dr.  Whipple  on,  137 
ideogenic  symptoms  of,  133 
illustrations  of,  132-143 
in  ill-balanced  brains,  254 
in    narrowed    consciousness, 

115 
is  not  shamming,  99 


INDEX  OF  SUBJECTS 


299 


Hysteria,  mental  cause  of,  133 

mind    often  not    normal  in, 

134 

never  voluntary,  113 
often  obscures  diagnosis,  129 
origin  of,  132 
partly  physical,  124 
phenomena  of,  132-143 
predisposing  cause  of,  133 
Prof.  Eichhorst  on,  126 
Prof.  Janet  on,  124 
sexual  element  in,  138 
Sir  James  Paget  on  the  name, 

115 

symptoms  of,  135 
the  process  in,  116 
therapeutics  of,  253-259 
use  of  word,  112 
Hysterical    abdominal    swellings, 

256 

aphasia,  138 
aphonia,  258 

dyspepsia,  Dr.  Ormerod  on,  139 
hydrophobia,  Dr.  Dale  on,  189 
paralysis,  128-140,  255 
spasm  of  gullet,  258 
tumours,  137,  256 
vomiting,  258 


IDEA,  paralysis  by,  141 

Ideal  centres  and  feelings,  121 

consultants,  21 

cures  from  ideal  centres,  230 
Ideas,  sensation  from,  122 
Ideogenic   symptoms  of  hysteria, 

133 

Idol  cures,  161 
Ignorance  about  functional  nerve 

disease,  99,  100 

Ignorance  revealed  by  language,  68 
Illustrations  of  curative  power  of 
mind,  211-224 

of  hysteria,  133 

of  V.M.N.,  174,  177 
Imaginary  diseases  and  diseases  of 

the  imagination,  99,  100 
Immunity,  V.M.N.  in,  180 
Importance  of  U.M.,  39 

of  the  mental  factor,  17 


Impressive  means,  value  of,  232 

Impressions,  prenatal,  94 

Inaugural  addresses,  190 

Incessant   adjustment   of   circula- 
tion, 55 

Index  of  resistance  to  disease,  171 

Indirect  agents  of  cure,  value  of, 
264 

Indirect  suggestions,  248 

Inert  drugs,  213 

Infectious  diseases  and  mind,  89 

Influenza,  Dr.  Clouston  on,  90 

Inner  chamber  of  mental  thera- 
peutics, 187 

Innumerable  quotations  in  book, 
ix 

Insanity  and  hysteria,  98 

from  fright,  Dr.  Tuke  on,  141 

Instinct  is  unconscious  mind,  30 

Intellect,  diseases  produced  by,  81 
emotions  and  will,  53 

Interaction  of  mind  and  body,  101 
of  physical  and  psychic,  76 

Interests  of  doctors,  190 

Intermittent    pulse,    Sir    B.    W. 
Richardson  on,  54 

Invalids  and  motor  cars,  153 

Irish    car,    medical    progress    re- 
sembles, 10 

Irrational  and  rational  ideas,  250 

Irritant,  U.M.  a  real,  43 

Isolation  in  cure  of  neurasthenia, 
247 


JAMES,  Prof.,  definition  of  mind, 

26 

on  psychology,  33 
on  unconscious    impressions, 

117 

on  U.M.,  86 

Janet,  Prof.,  on  hysteria,  124 
Judgment  not  clear  at  night,  76 
Jugglery,  medical,  5 


KIDNEY  disease,  mental  origin  of, 

87 

power  of  conscious  mind  over, 
52 


300 


THE  FOKCE  OP  MIND 


LABOUR  and  the  clock,  216 

Ladd,  Prof.,  on  psychic  force,  48  ; 

on  reality  of  mind,  16 
•  Lancet '  on  faith-healing,  198  ;  on 

mental  factor,  192;   on  mental 

therapeutics,  185,  201 
Language  reveals  ignorance,  68 
Latent  interval  in  reflexes,  42 
Law  of  gravitation,  25 
Laycock,  Dr.,  on  effect  of  mind  on 

cornea,  174  ;  on  physiognomy  of 

disease,  76 

Lazarus,  Prof.,  on  the  U.M.,  44 
Lectures,  none  on  force  of  mind,  13 
Letter  from  Sir  J.  Paget,  1 ;  value 

of,  7 

on  mental  therapeutics,  149 
to  Sir  H.  Acland,  2 
Life  and  existence,  51 
List  of  diseases  cured  by  faith,  160 

of  hysterical  symptoms,  135 
Liver  and  the  mind,  85 

disease  and  mind,  Dr.  Mur- 

chison  on,  221 

Livy  on  mental  therapeutics,  182 
Local  expressions  of  emotion,  54 
Loss  of  reason  and  heart  disease, 

214 

Louise  Lateau  and  U.M.,  61 
Lourdes,  159 

Lowe,  Dr.,  on  mind  in  pairing,  92 
Lung  diseases  of  mental  origin,  83 
Lungs,  power  of  conscious  mind 

over,  52 
Lys,  Dr.  G.,  on  Graves'  disease,  90 ; 

on  mind  and  disease,  80 


MACHINES,  men  treated  as,  14 
Macpherson,  Dr.,  on  psychology,  33 
Maeterlinck  on  protozoa,  29 
Malingering  and  functional  nerve 
disease,  226 

and  hysteria,  99 
Maltreatment  of  functional  nerve 

disease,  225 
Man  as  a  whole,  21 
Manner  as  a  cause  of  disease,  270 

as  a  cure  of  disease,  271 

in  medicine,  189 


'  Man  '  specialist  required,  15 
Many  observers,  few  reasoners,  16 
Maps,  fiction  in,  68 
Matteism,  159 

Maudsley,  Dr.,  on  mental  thera- 
peutics, 183  ;  on  U.M.,  35 
Meaning  of  V.M.N.,  168 
Mechanical,  medicine  is  not,  153 
theories  and  vital  action,  34 
Medical  jugglery,  5 
mind  of  1866,  2 
neglect  encourages  quackery, 

18 

philosophy  out  of  fashion,  10 
progress  like  Irish  car,  10 
science,  the  Cinderella  of,  228 
'  Medical  Times '  on  mental  factor, 

191 ;  on  psychic  force,  48 
Medicine,    advance    in,  real    and 

great,  10 

altruistic  note  in,  190 
freed  from  pseudo-psychology, 

9 

manner  in,  189 
not  mechanical,  153 
one-sided  advance  in,  9 
philosophy,  theology,  20 
system  of  deficient,  13 
the  weak  spot  in,  272 
Memory  and  hypnotism,  206 

power  of,  118 

Mental  action  in  spinal  disease,  29 
causes  of  hysteria,  133 
curative  qualities,  209 
diseases,  Dr.  Clouston  on,  84 
factor  determines  nerve  dis- 
ease, 102 

Dr.  H.  Tuke  on,  18 
importance  of,  17 
in  disease,  80-97 
in  nerve  disease,  69 
« Lancet '  on,  192-201 
•Medical    Times'    on, 

191 
plays    small    part    in 

disease,  69 
Prof.  Bowen  on,  192 
Sir  B.  Brodie  on,  18 
Sir  J.  C.  Browne  on, 
18, 191 


INDEX  OP  SUBJECTS 


301 


Mental  factor  ubiquitous,  69 

value  of,  to  physician, 

191 

Mental  influence,  Dr.   de  Fleury 
on, 194 

Dr.  Eush  on,  194 
Mental  origin  of  anaemia,  83 

of  anasarca,  83 

of  atheroma,  83 

of  dyspepsia,  84 

of  jaundice,  84 

of  kidney  disease,  84 

of  lung  disease,  84 

of  vomiting,  85 
Mental  senses  other  than  sight,  36 

shock  and  reflex  pain,  90 

state  at  night  peculiar,  74 

states  and  body  organs,  49 

strain  and  nerve  disease,  107 

Sir  J.  Paget  on,  107 
Mental  therapeutics,  and  success, 
21 

antiquity  of,  101 

•Brit.  Med.  Journ.'  on,  163; 
on  difficulty  of,  11,  70 

dislike  of,  148 

Dr.  Affleck  on,  186 

Dr.  Beard  on,  185 

Dr.  E.  B.  Carter  on,  183 

Dr.  Cathell  on,  184 

Dr.  Clouston  on,  99,  151,  184 

Dr.  Dale  on,  184 

Dr.  de  Fleury  on,  181 

Dr.  Gibert  on,  221 

Dr.  Granville  on,  183 

Dr.  Maudsley  on,  183 

Dr.  Morrison  on,  182,  187 

Dr.  A.  T.  Myers  on,  200 

Dr.  Playfair  on,  183 

Dr.  Bx)bertson  on,  184 

Dr.  J.  H.  Sealy  on,  186 

Dr.  Shoemaker  on,  184 

Dr.  H.  Tuke  on,  185 

four  reasons  for  dislike  of,  12 

and  functional  nerve  diseases, 
225-232 

inner  chamber  of,  87 

'  Lancet '  on,  185 

letter  on,  149 

methods  of,  195 


Mental  therapeutics,  neglected  in 
practice,  14;  in  teaching,  13 

no  book  on,  181 

not  in  text-books,  200 

not  jugglery,  6 

Sir  A.  Clarke  on,  182 

Sir  John  Forbes  on,  185 

Sir  S.  Wilks  on,  184 

varieties  of,  190-210 
Men  treated  as  machines,  14 
Metabolism  and  morbid  minds  16 

in  U.M.,  60 
Metaphysical  healing  by  Christian 


Methods  of  cure  in  neurasthenia, 
242 

of  indirect  suggestion,  275 

of  mental  therapeutics,  295 
Mimicry,  conscious,  is  fraud,  114 

neuromimesis  more  than,  142 
Mind  and   body,  always  interact, 
101 

connected  in  melancholy,  9 

Dr.  Calderwood  on,  19 

Dr.  Clouston  on,  19 

Dr.  de  Fleury  on,  20 

Dr.  B.  Bush  on,  47 

killed  by  overwork,  96,  114 

like  coupled  dogs,  167 

Prof.  Gairdner  on,  20 

Sir  F.  Bacon  on,  70 

the  organs  of,  49 
Mind  and,  calculus,  88 

cancer,  88 ;  Dr.  Snow  on,  88 

cholera,  89 

cortex,  73 

digestive  canal,  85 

faecal  vomiting,  86 

heart,  Dr.  Huchard  on,  82 

infectious  diseases,  89 

matter,  Herbert   Spencer  on, 
17 

matter,  Spinoza  on,  31 

motion,  50 

nerve  diseases,  239 

nutrition,  73 

scurvy,  89 

sensation,  49 

skin  secretions,  89 

surgical  operations,  221 


302 


THE  FORCE  OF  MIND 


Mind  and,  the  liver,  86 
the  urine,  88 
tumours,  88 
uterine  disease,  91 
Mind,  Aristotle  on,  37 

as  cause  and  cure  of  disease, 

148 

below  the  protozoa,  29 
body  and  morals,  78 
causes,  death  from,  95 
conflict  about,  43 
cures,  Dr.  Clouston  on,  165; 

liver     disease,     221;     not 

limited  to  function,  164 
definition  of,  Prof.  James's,  26 
Descartes  on,  37 
disease  of  heart  produced  by, 

82 

drugs  altered  by,  211 
effects  of  day  and  night  on, 

74 

essential  unity  of,  26,  42 
force  of,  very  small  in  many 

diseases,  viii 
illustrations  of  curative  power 

of,  211 

in  cholera,  Dr.  Stokes  on  in- 
fluence of,  89 
includes  U.M.  action,  40 
disease,  Dr.  Clouston  on,  72 ; 

Dr.  Goodbart  on,  71;   Dr. 

Bennie  on,  71 ;  Sir  J.  Paget 

on,  71 
influence,  '  Brit.  Med.  Journ.' 

on,  11 
in  pairing,  Dr.  Lowe  on,  92 ; 

Dr.  Neale  on,  93 
in  spinal  disease,  222 
Maudsley  on  unconscioua,  85 
muscles  of  the  face,  76 
not  confined  to  consciousness, 

35 
not  limited  to  what  we  see, 

36 

not  threefold,  40 
not  twofold,  41 
•  Mind '  of  Galen,  37 
Mind  often  not  normal  in  hysteria, 

134 
of  the  physician,  22 


Mind  on  body,  dependence  of,  156 ; 
every-day    effects    of,    74 ; 
threefold  action  of,  47,  67 
reversed  peristalsis,  85 
Bibot  on  unconscious,  35 
synonymous   with    conscious- 
ness, 35 

unity  of,  25,  40,  46 
what  is  it?  30 
White  on,  42 

Mitchell,  Dr.,  on  cure    of    neur- 
asthenia, 249 

Mixed  motives,  the  valne  of,  191 
Models  and  U.M.,  60 
Modern  physiologies  purely  scien- 
tific, 12 

Monists  or  dualists,  16 
Morals,  mind,  and  body,  78 
Morbid  minds  and  metabolism,  16 
Morrison,  Dr.  A.,  on  mental  thera- 
peutics, 182,  187 
Motion  and  mind,  50 
Motor  cars  and  invalids,  153 
Murchison,  Dr.,  on  liver   disease, 

221 ;  on  minr  and  cancer,  88 
Murderers  and  the  U.M.,  57 
Muscles  and  spurs,  211 
and  U.M.,  58 
striped  and  unstriped,  59 
voluntary  and  U.M.,  59 
Myers,  Dr.  A.  T.,  on  mental  thera- 
peutics, 200 


NAME  needed  for  psychic  force,  31 
Narrowed   consciousness    in    hys- 
teria, 115 
'  Nature  '  and  '  physiology  '  useless 

names,  32 

Nature's  therapeutics,  180 
Nauseous  '  gums,'  Dr.  B.  Beynolda 

on,  230 

Neale,  Dr.,  on  mind  in  pairing,  93 
Necrosis  and  hysteria,  140 
Neglect,  treatment  by,  229,  267 
Nelson's  arm  and  U.M.,  59 
Nerve  and  mind  disease,  239 
cures,  Dr.  Playfair  on,  231 
disease  after  cure,  251 
disease  and  mental  strain,  107 


INDEX  OF  SUBJECTS 


303 


Nerve  disease  determined  by  men- 
tal factor,  102 
disease,  four  types  of,   103 ; 

mental  factor  in,  69 ;   Sir 

B.  W.  Kichardson  on,  80 
doctor,  De  Fleury  on,  231 
nurse    follows    doctor's  lead, 

277 

nurse  hard  to  find,  244 
or  muscular  system,  are  there 

two  ?  244 

sufferers  much  wronged,  226 
Nervous    diathesis,  Clouston    on, 

102 

diathesis  described,  103 
dyspepsia,  Dr.  Dale  on,  287 
system,  Dr.  Allbutt  on,  106; 

discontinuance  of,  43  ;  pain 

and  cure  over,  53 
Neurasthenia,  104 

a  distinct  disease,  104 

and  education,  106 

and  Noah's  dove,  104 

and  sexual  excesses,  10 

and  society,  107 

causes  of,  106, 108 

cure,  details  of,  246 

Dr.  Beard  on,  109 

Dr.  Mitchell  Bruc    on  cure  of, 

249 
Dr.  Herman  on  symptoms  of, 

109 

Dr.  Karl  Petren  on,  107 
isolation  in  cure  of,  247 
methods  of  cure,  242 
not  hypochondria,  104 
physical  factor  in,  109 
prophylaxis  in,  252 
varieties  of,  105 

Neurasthenics  and  America,  104 
and  France,  104 
Dr,  Allbutt  on,  106 
three  classes  of,  105 
Neuron?  imesis  and  the  U.M.,  123, 

125 
is  unconscious  mimicry,  115, 

134 

more  than  mimicry,  142 
not  conscious  effort,  113 
not  shamming,  113 


Neuromimesis,  Sir  J.  Paget  on,  125 

symptoms  of,  135 
Neuropaths  and  great  men,  101 
Neuroses  and  heredity,  102 
New  classification  of  disease,  224 

fields  of  study,  273 

name  for  U.M.,  126 

nomenclature  needed,  143 

text-books,  274 
Night,  diseases  worse  in,  74 
Nitrogen  and  suggestion,  228 
Noah's  dove  and  neurasthenia,  104 
No  mind  outside  of  consciousness, 

31 

No  miracle  in  faith-healing,  198 
'  Not  the  body,  but  the  man  is  ill,' 

15 

Nurse  and  doctor,  co-operation  of, 
241 

cured  by  will  power,  219 
Nursery  and  the  clock,  217 
Nurses  and  neurasthenia,  244 
Nursing  homes,  245;  and  doctors, 

245 
Nutrition  and  mind,  73 

and  the  V.M.N.,  173 


OBSERVATION  and  diagnosis,  77 

and  stethoscope,  77 
Omission  in  book,  ix 
Organic  and  functional,  68,  70 

and  functional  disease,  129 

change  and  pain,  134 

disease    and    hysteria,    127 ; 

have  functional  basis,  101 
Organism,  Dr.  Gharrin  on  defences 
of,  177 

selective  action  of,  174 
Origin  of  hysteria,  132 
Ormerod,  Dr.,  on  hysteria,  92,  124 

on  hysterical  dyspepsia,  139 
Orthodox  cures,  162 
Over  education  and  hysteria,  255 
Overwork  and  wranglers,  96 

kills  mind  and  body,  96 


FACET,  Sir  George,  on  mind  in 
cancer,  88 


304 


THE  FOECE  OF  MIND 


Paget,  Sir  James,  biography,  1 
letter  from,  1 
on  mental  strain,  107 
on  mind  in  disease,  71 
on  neuromimesis,  113, 125 
on  the  word  'hysteria,' 

115 

Pain  and  organic  changes,  134 
and  the  mind,  214 
in  little  finger,  119 
Pairing,  effects  of  mind  in,  192 
Paracelsus  on  faith-healing,  197 
Paradox  of  quackery,  154 
Paralysis    agitans    and    hysteria, 
141 ;    paralysis   by  idea,    141  ; 
hysterical,   128,   140,  253;   Dr. 
Dale  on,  267 

Paraplegia,  Dr.  Buzzard  on,  265 
hysterical  treatment  of,  265 
Par6,  Ambrose,  on  V.M.N.,  176 
Patience,  value  of,  235 
Peculiar  mental  state  at  night,  75 
Peristalsis  reversed  by  mind,  85 
Perseverance,  value  of,  235 
Personal  value  of  the  doctor,  22 
Petren,  Dr.  Karl,  on  neurasthenia, 

107 
Pharynx,  conscious  control  ceases 

at,  87 

Phenomena  of  hysteria,  132-143 
Philosopher,  priest,  and  alienist,  20 
Philosophy,  theology,  and  medicine, 

20 

Physical    and  psychic  action    of 
drugs,  212  ;  interaction,  76 
aspect  in  U.M.,  62 
in  neurasthenia,  109 
phenomena,  hypnotism,  288 
side  of  hysteria,  124 
Physician's  assets,  a,  23 
mind,  the,  22 

personality,  Cassiodorus  on, 
192  ;  Celsus  on,  192 ;  Dr. 
O.  W.  Holmes  on,  193 ; 
Dr.  Sealy  on,  188 ;  Dr.  Or. 
Sharp  on,  187  ;  Dr.  H.  G. 
Button  on,  188 

Physicians  not  confined  to  physic,  9 
Physiognomy  of  disease,  J)r.  Lay- 
cock  on,  76 


Physiology  and  female  doctors,  38 
and  Hippocrates,  37 
and  nature,  useless  names,  32 
Picture  of  the  U.M.,  44 
Pigeons  and  hens,  27 
Pious  deceptions,  Sir  F.  Semon  on, 

263 

Placebos,  Sir  F.  Semon  on,  262 
Playfair,  Dr.,  on  mental  therapeu- 
tics, 183 

on  nerve  cures,  231 
Pliny  on  mental  therapeutics,  182 
Power  of  bold  quack,  4 

of  doctor's  face,  193,  210 
of  conscious  mind  over  diges- 
tion, 52  ;  heart,  51 ;  kidneys, 
52  ;  lungs,  51 ;  nervous  sys- 
tem, 53 

of  memories,  118 
of  the  V.M.N.,  275 
Practical  conclusion,  270 
value  of  subject,  273 
Practice,  mental  therapeutics   ne- 
glected in,  14 

Practitioners,  successful  and  unsuc- 
cessful, 23 

Prayer-healing  in  Germany,  201 
'  Predisposing '  cause  of  book,  vii 

cause  of  hysteria,  133 
Pregnancy,  Dr.  Ormerod  on,  92 

Dr.  Owen  on,  92 
Prenatal  impressions,  94 

C.  Kingsley  on,  94 
Priest,  philosopher,  patient,  20 
Prince,  Dr.  M.,  and  hay  fever,  58 
Process  in  hysteria,  116 
Prophylaxis  in  neurasthenia,  252 
Protozoa,  Maeterlinck  on,  29 

mind  below  the,  29 
Pseudo  faith-healers,  157 
religious  quacks,  156 
Psychic  element  in  sensory  motor 

reflexes,  65 
force,  Ladd  on,  48 
force,  '  Medical  Times '  on,  48 
force,  name  needed  for,  32 
qualities  and  success,  23 
Psychism  in  ganglionic  centres,  29 
Psychological  action  in  the  eye, 
188 


INDEX  OF  SUBJECTS 


305 


Psychological  section   at   British 

Medical  Association,  8 
Psychology,  Dr.  C.  Bastian  on,  33 
and    the    British    Medical 

Association,  8 
and  the  diseased  mind,  8 
chaos  of,  33,  34 
Dr.  Macpherson  on,  83 
Professor  James  on,  33 
shibboleth  of,  33 
Psycho-pathology,  67-79 

general  view  of,  68 
Psycho-physiology,  on,  47-66 
Psycho-therapy,  on,  147-167 
Public  and  cures,  150 
Pulse,    intermittent,    Sir    B.    W. 

Richardson  on,  54 
Purposive  action  in  amoeba,  27 
Pye- Smith,      Professor,       denies 
V.M.N.,  169 


QUACK  and  regular  in  8.  Africa,  6 

cures,  some  genuine,  154 
Quackery  encouraged    by  medical 

neglect,  18 

Quackery,  paradox  in,  154 
Quack,  power  of,  2 

remedies    not    always    inert, 

155 

Quacks,  pseudo-religious,  106 
Quacks,  why  they  flourish,  150 
Qualities,  curative,  Sir  J.  C.  Browne 

on,  209 

curative,  Sir  J.  Forbes  on,  209 
mental  curative,  209 
Question  of  double  consciousness, 
138 


RATIONAL  and  irrational  ideas,  260 
Reality  of  mind,  Prof.  Ladd  on,  16 
Realm,  the  conscious,  51 
Reason  alone  no  guide,  53 
for  writing  book,  272 
Recent   recognition  of  functional 

nerve  disease,  98 
Reflex  pain  and  mental  shock,  90 
Reflexes,  latent  interval  in,  42 
Regular  and  quack  in  8.  Africa,  6 


Relic  cures,  161 

Religion,  true  value  of,  260 

Rennie,  Dr.,   on    functional 
organic  symptoms,  129 

Rennie,   Dr.,  on  functional 

disease,  128 
on  hereditary  neuroses,  102 
on  hysteria,  112 
on  mind  in  disease,  71 

Resistance    to    disease,  index  of, 

Respiration  and  U.M.,  57 
Rest  in  bed  in  neurasthenia,  247 
Reversed  peristalsis  and  mind,  85 
Review  of  chapters,  277-282 

of  faith-healing,  196 
Revolution,  silent,  going  on,  164 
Ribot  on  U.M.,  35 
Richardson,    Sir    B.    W.,    denies 
V.M.N.,  169 

on  diabetes,  87 

on  intermittent  pulse,  54 

on  nerve  diseases,  80 

on  skin  secretion,  89 
Rickets  and  the  V.M.N.,  178 
Ritchie,  Dr.  G.,  on  consciousness 

and  mind,  35 

Robertson,  Dr.,  on  mental  thera- 
peutics, 184 

Romanes  on  rotifers,  28 
Rotifers,  Romanes  on,  28 
Routine  is  bad  in  nerve  cases,  251 
Rush,  Dr.  B.,  on  mental  influence, 
194 

on  mind  and  body,  47 
Russell  Reynolds,  Dr.,  on  hysterical 
paralysis,  140 

on  nauseous  '  gums,'  230 

SAFETY-VALVE     actions    in    body, 

176 

Saint  cures  typhoid  fever,  218 
Science  and  health,  157 
shibboleths  in,  147 
Scurvy  and  mind,  89 
Sealy,  Dr.  J.  H.,  on  mental  thera- 
peutics, 185 
on  personality  of  the  physician, 


306 


THE  FOKCE  OF  MIND 


Seat  of  conscience,  46 

of  sensation  in  brain,  118 
Secondary  consciousness,  208 

Prof.  Biener  on,  125 
Selective  action  of  organism,  174 
Semon,  Sir  F.,  on  pious  deceptions, 
263 

on  placebos,  262 
Sensation  and  hysteria,  141 

and  mind,  49 

Dr.  Hack  Tuke  on,  63 

from  ideas,  122 

in  the  hand,  122 

in  the  teeth,  122 
Sensations  from  ideas,  122 

seat  of,  in  brain,  118 

unconscious,  116 
Senses  and  Christian  science,  70 
Sensori-motor  reflexes  and  psychic 

element,  65 
Sexual  element  in  hysteria,  138 

excesses  in  neurasthenia,  209 
Shamming  and  hysteria,  99 
Sharp,  Dr.  G.,   on   personality  of 

physician,  188 
Shibboleth  of  psychology,  34 
Shibboleths  in  science,  147 
Shoemaker,  Dr.,  on  mental  thera- 
peutics, 184 
Sight  and  U.M.,  63 

not  only  mental  sense,  36 
Silent  revolution  going  on,  164 
Sins  of  ignorance,  271 
Skin  and  U.M.,  61 

secretions  and  mind,  89 
Slothful  neuropaths,  Dr.  de  Fleury 

on, 106 
Small  part  played  by  mental  factor, 

69 

Smell  and  U.M.,  65 
Snow  on  mind  in  cancer,  88 
Society  and  neurasthenia,  107 
Solomon,    King,    on    physician's 

personality,  193 
Soul,  spirit,  and  body,  20 
Sound  cortex,  Dr.  Clouston  on,  96 
Sounds  and  subjective  sensations, 

121 

South  African  war,  6 
Spaa,  cures  at,  161 


Spasm  of  gullet,  hysterical,  258 
Specialists,  abundance  of,  14 
Special  senses  and  hysteria,  138 

work  of  U.M.,  275 
Spectrum,  conscious  mind  as,  45 
Spencer,  Herbert,  on  law  of  equi- 
libration, 170 
on  mind  and  matter,  17 
Spinal  cord,  mental  action  in,  29 
Spinal  disease,  mind  in,  222 
Spinoza  on  mind  and  matter,  81 
Spirit,  soul,  and  body,  20 
Standing  in  a  rapid  stream,  viii 
Stethoscope  and  observation,  77 
Stigmata  and  U.M.,  61 

Prof.  Barrett  on,  62 
Stratagem  of  John  Hunter,  230 
Striped  and  unstriped  muscles,  69 
Structural    change  and  hysteria, 

130 
Subjective  sensations  and  sounds, 

21 

Subject,  practical  value  of,  273 
Success   and  mental  therapeutics, 

21 

and  psychic  qualities,  23 
Successful  and  unsuccessful  prac- 
titioner, 23 

Suggestions,  bad,  must  be  removed, 
229 

best  if  indirect,  248 
not  absorbed  if  direct,  228 
Summary  of  book,  277-282 
Superficial  diversity  and  combining 

unity,  25 
Surgical  operations  and  the  mind, 

222 

Surroundings,  old,  are  bad,  248 
Button,    Dr.    H.    G.,    on    mental 

therapeutics,  185 
on   personality   of  physician, 

188 

Sweetzer,  Dr.,  on  haemoptysis,  84 
Sydenham,  Dr.,  on  gout  and  mind, 

221 

Sympathetic  origin  of  diseases,  82 
Sympathy  in  treatment,  234 

value  of,  186,  195 
Symptoms    of    functional    nerve 
diseases,  98-111 


INDEX  OF  SUBJECTS 


307 


Symptoms  of  hysteria    105;   Dr. 
Buzzard  on,  255 ;  ideogenio, 
133 
of  neurasthenia,  Dr.  Beard  on, 

109 

neuromimesis,  135 
Syndicate,  body  not  a,  33 
System  of  medicine  deficient,  13 


TACT,  value  of,  236 

Taste  and  U.M.,  65 

Teaching  mental  therapeutics,  18 

Teeth,  sensations  in,  121,  122 

Temperament  and  disease,  75 

Temperature  and  hysteria,  140 

Terms  of  expectation,  101 

Test  for  murderers,  57 

Text-books  on  mental  therapeutics, 
200 

Theology,  philosophy,  and  medi- 
cine, 20 

Therapeutics  and  will,  209 
general,  of  hysteria,  261 
of  hysteria,  253-269 
mental,  antiquity  of,  101 
Dr.  Affleck  on,  186 
Dr.  Beard  on,  185 
Dr.  Carpenter  on,  201 
Dr.  Carter  on,  183 
Dr.  Clouston  on,  184 
Dr.  Dale  on,  184 
Dr.  de  Fleury  on,  187 
Dr.  Gibert  on,  221 
Dr.  Gibson  on,  261 
Dr.  Granville  on,  183 
Dr.  Maudsley  on,  183 
Dr.  Morrison  on,  182 
Dr.  Playfair  on,  183 
Dr.  Bx)bertson  on,  184 
Dr.  J.  H.  Sealy  on,  185 
Dr.  Shoemaker  on,  184 
Dr.  H.  G.  Button  on,  185 
Dr.  H.  Tuke  on,  185 
Gliddon  on,  181 
in         functional 

diseases,  225-232 
inner  chamber  of,  187 
•Lancet 'on,  185,201 
Livy  on,  182 


Therapeutics,  mental,  no  books  on, 

181 

not  in  text-books,  200 
Sir  A.  Clark  on,  182 
Sir  J.  Forbes  on,  185 
Sir  S.  Wilks  on,  184 
value  of  fear  in,  210 
varieties  of,  190-210 
natural,  180 
power  of  clock  on,  216 
Thinking  and  feeling,  120 
Thought,  advance  in  current,  10 
Three  classes  of  neurasthenics,  105 
Threefold  action  of  mind  on  body, 

47,67 

Time  sense  in  hypnotism,  207 
Title  of  book,  why  chosen,  44 
Touch  and  U.M.,  65 

value  of,  232 
Trained    nerve    nurse    does    not 

exist,  277 

Trance  of  Louise  Lateau,  61 
Treatment  useless  without  V.M.N., 

179 
Treatment    of    functional    nerve 

diseases,  233-252 
honesty  in,  238 
of  neglect,  229,  267 
of  sympathy,  234 

Tuke,  Dr.  H.,  and  mental  thera- 
peutics, 185,  221 
on  death  from  mental  causes, 

95 

on  hearing,  64 
on  insanity  from  fright,  141 
on  intellect,  emotion,  and  will, 

53 

on  mental  factor,  18 
on  sensation,  63 
Tumours  and  mind,  88 
hysterical,  137,  256 

cure  of,  237 
Typhoid  fever  cured  by  saint,  218 


UBIQUTTT  of  mental  factor,  69 
Ulcer,  gastric,  Dr.  Bigi  on,  189 
Unconscious      impressions,      Dr. 
Waldstein  on,  117 ;  Prof.  Barrett 
on,  117 ;  Prof.  James  on,  117 


308 


THE  FOECE  OE  MIND 


Unconscious   mimicry    in    neuro- 

mimesis,  114,  134 
Unconscious  mind,  action  and  ex- 
amples, 56 

action  included  in  mind,  40 

and  ancients,  37 

and  artists,  60 

and  blood-vessels,  55 

and  circulation,  54 

and  digestion,  56 

and  face,  59 

and  Francis  of  Assisi,  61 

and  German  bands,  56 

and  hay  fever,  58 

and  hearing,  64 

and  hypnotism,  205 

and  the  heart,  52 

and  instinct,  30 

and  metabolism,  60 

and  models,  60 

and  murderers,  57 

and  muscles,  58 

and  Nelson's  arm,  59 

and  neuromimesis,  123,  125 

and  physical  aspect,  62 

and  respiration,  57 

and  sight,  63 

and  skin  and  hair,  61 

and  smell,  65 

and  stigmata,  61 

and  stomach,  57 

and  taste,  65 

and  touch,  65 

and  voluntary  muscles,  69 

and  waking,  208 

a  real  irritant,  43 

Eastian  on,  40 

great  action  of,  39 

great  curative  agent,  162 

hysteria,  a  disease  of,  113 

hysteria  cured  through,  227 

importance  of,  39 

is  the  V.M.N.,  179 

Maudsley  on,  35 

natural,  60 

new  name  for,  126 

picture  of,  44 

powers     of,     revealed     by 
hypnotism,  206 

Prof.  Barrett  on,  61 


Unconscious  mind,  Prof.  Hoffding 

on,  36 

Prof.  James  on,  36 
Prof.  Lazarus  on,  44 
Eibot  on,  35 
special  work  of,  275 
the  real  healer,  274 
Von  Hartmann  on,  43 
sensations,  116 

Unity  controlling  the  body,  32 
in  diversity,  12,  32 
in  true  physiology,  26 
of  body,  33 
of  mind,  25-46 

essential,  26 
Unzer  on  psychic  action  of  drags, 

212 

Urinary  system  and  hysteria,  139 
Urine  and  the  mind,  88 
Useless  names, '  nature '  and '  phy- 
siology,' 32 
Uselessness  of  difficult  suggestions, 

230 

Use  of  word  '  hysteria,'  116 
Uterine  disease  and  mind,  91 
Uterus  and  mind,  Dr.  Herman  on, 
109 

VALUE  of  cheerful  countenance,  194 

of  common-sense  talk,  260 

of  details,  238 

of  drugs,  164 

of  face  in  disease,  76 

of  family  physician,  195 

of  fear  in  therapeutics,  210 

of  impressions,  232 

of  indirect  agent  of  cure,  264 

of  patience,  235 

of  perseverance,  235 

of  pure  water,  266 

of  sympathy,  186, 196 

of  tact,  236 

of  touch,  232 

of  true  religion,  260 

to  physician  of  mental  factor, 

191 

Van  Noorden  on  diabetes,  87 
Varieties  of  faith  cures,  202 

of  mental  therapeutics,  190. 
210 


INDEX  OF  SUBJECTS 


309 


Varieties  of  neurasthenia,  103 
Vegetarians,  203 

Vibrations,  conscious  and  uncon- 
scious, 117 
Victory  and  defeat,  effect  on  health, 

89 

Virtue  of  mixed  motives,  191 
Vis  medicatrix  natures,  168-189 

Ambrose  Par6  on,  176     • 
and  growth,  173 
art  of  healing  depends  on, 

172 

Dr.  Charrin  on,  177 
Dr.  Mitchell   Bruce    on, 

172-176 

Hippocrates  on,  176 
illustrations  of,  174,  177 
in  digestion,  179 
in  immunity,  180 
not  a  force,  168 
nutrition  and  the,  173 
power  of,  275 
Prof.  O.  W.  Holmes,  175 
resists  disease,  175 
Sir  T.  L.  Brunton  on,  179 
Sir  W.  S.  Church  on,  176 
Sir  S.  Wilks  on,  172 
treatment  useless  without, 

179 
Vital  action  replaces  mechanical 

theories,  321 

Vitalising  dead  material,  19 
Vitality  of  quackery,  cause  of,  151 


Volt's  pigeons  and  Flourens'  hens, 

27 
Volition  in  amoeba,  Sir  W.  Dawson 

on,  28 
Voluntary    hysteria    non-existent, 

113     ' 

muscles  and  U.M.,  59 
Vomiting,  hysterical,  258 

WAKING  and  U.M.,  208 
Waldstein,    Dr.,    on    unconscious 

impressions,  117 
Walshe,  Dr.,  on  death  from  mental 

causes,  95 

War  in  South  Africa,  6 
Weak  spot  in  medicine,  277 
What  is  functional  disease  ?  159 

is  mind  ?  30 
When  is  a  man  ill?  99 
Whipple,  Dr.,  on  hysteria,  187 
White  on  mind,  42 
Why  quacks  nourish,  160 
Wilkinson,  Dr.,  on  V.M.N.,  172 
Wilks,  Sir   S.,  on  mental  thera- 
peutics, 208 

Will  and  therapeutics,  209 
intellect,  and  emotion,  53 
power  and  typhoid  fever,  219 
power  cures  nerves,  219 
Worship  of  female  deities,  38 
Wranglers  and  overwork,  96 

ZEITGEIST,  the,  149 


Vital   Helps    Toward   Health    and    Happiness 

Four  Imftrtant  Both  \>j  A.  T.  SCHOFIELD,  Af.D.,  M.R.C.S.f 


"  Dr.  Schofleld  Is  a  good  example  of  the  highest 
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of  Information  bearing  upon  the  subject*  of  which 
he  writes. "-Good  Health,  New  York. 


NERVES 

IN  DISORDER 

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